Evaluation of Clinical Manifestation, Demographics Parameters and Causes of Chest Pain in Children

Background:

 Chest pain is one of the common chief complaints in children which can be benign and/or life-threatening. In this retrospective study, the causes of chest pain, associated factors, and clinical characteristics in children have been evaluated in order to have a better diagnosis and clinical approach.

680 patients with chest pain were referred to the pediatric cardiology clinic from Jan 2017 to July 2019. All the information about past medical history, family history, chest pain characteristics, and associated symptoms were collected and all the body systems were examined. The patients who were suspected to have psychological problems were referred to psychiatrists for evaluation. The data were indicated as counts and percentages. Statistical analyses were performed using SPSS (version 20.0).

The most frequently reported symptoms accompanied with chest pain were palpitation and exertional dyspnea. 111 patients had abnormal echocardiography and 32 of them had abnormalities in ECG. Dyslipidemia was detected in one of the obese children. The most common causes of chest pain were idiopathic (42.4%), cardiac origins (22.2%), musculoskeletal (13.8%), psychiatric problems (8.6%), gastrointestinal (6.6%), respiratory (5.6%), and gynecomastia (0.08%) respectively. Cardiac chest pain was the most common type among the children between 15 and 18 years old. 

Conclusion:

 The causes of chest pain could be diagnosed by history-taking, physical exams, and cardiac auscultation. Further tests such as echocardiography, ECG, chest X-ray, and laboratory tests were not essential to diagnose cardiac pains as the first line evaluation.