Chest pain in children and adolescents: what does the pediatrician need to know?

Abstract

Introduction: chest pain is a common complaint among children and adolescents, most of the etiologies are benign and of non-cardiac origin. However, it is a cause of concern and anxiety for the patient and his family for fear of being associated with a heart disease or the risk of sudden death. Objective: to perform a review of the main causes of chest pain in pediatrics, how to perform a differential diagnosis between cardiac and non-cardiac causes, when to request complementary tests and when referral to a pediatric cardiolo­gist if cardiac disease is suspected and what is the appropriate treatment. Data source: this review was performed in the Medline database, using the keywords: ‘chest pain’, ‘child’, ‘adolescent’, ‘pediatrics’. Data synthesis: chest pain in childhood corresponds to 0.3 to 0.6% of pediatric emergency department visits; the most frequent etiology is of non­-cardiac origin; for correct diagnosis history and physical examination are fundamental and indicate the need for complementary examinations; the treatment should be directed to the etiology. Conclusions: performing the correct approach to chest pain in childhood and adolescence and determining the differential diagnosis of benign or cardiac causes is a challenge for pediatricians.