Is my child's chest pain serious?

Chest pain in children can be alarming for parents, raising concerns about serious health issues, particularly those related to the heart. It’s important to understand the various causes of chest pain in children and determine when it might indicate a serious condition. Leading consultant paediatric cardiologist Dr James Wong goes into expert detail about this crucial topic in this informative article.

What are the common causes of paediatric chest pain?

Chest pain in children is relatively common and is often not related to the heart. The majority of cases are benign and can be attributed to musculoskeletal issues, respiratory conditions or gastrointestinal problems. Common causes include:

• Musculoskeletal pain: The most common cause of chest pain in children. It can result from muscle strain, inflammation of the cartilage in the chest wall (costochondritis) or minor injuries.
• Respiratory conditions: Conditions such as asthma, bronchitis or pneumonia can cause chest pain. These are usually accompanied by other symptoms like coughing, wheezing, or difficulty breathing.
• Gastrointestinal issues: Acid reflux or gastritis can cause chest pain. Children may describe a burning sensation or discomfort in the chest, which can often be mistaken for heart-related pain.

When should I worry about chest pain?

While most chest pain in children is not serious, certain symptoms may indicate a need for immediate medical attention. If your child experiences any of the following, it is important to seek medical advice promptly:

• Persistent or severe pain: If the chest pain is severe, persistent, or getting worse over time, it should be evaluated by a healthcare professional.
• Associated symptoms: Chest pain accompanied by symptoms such as shortness of breath, fainting, palpitations or dizziness could indicate a more serious condition and should be investigated.
• Exertional pain: Pain that occurs during physical activity or exercise may suggest a cardiac origin and warrants further examination.
• Family history: A family history of heart disease or sudden cardiac death increases the concern for a cardiac cause of chest pain in children.

What are the cardiac causes of chest pain?

While rare, there are cardiac conditions that can cause chest pain in children. These include:

• Pericarditis: Inflammation of the lining around the heart can cause sharp, stabbing chest pain. This pain may worsen with deep breaths or lying down.
• Myocarditis: Inflammation of the heart muscle, often due to viral infections, can cause chest pain along with symptoms such as fatigue and palpitations.
• Congenital heart defects: Some congenital heart defects may present with chest pain, especially if they affect the blood flow or pressure within the heart.
• Arrhythmias: Abnormal heart rhythms can cause palpitations and chest discomfort.

How is paediatric cardiac chest pain diagnosed?

To determine the cause of your child's chest pain, a thorough medical history and physical examination are essential. Depending on the findings, additional tests may be required, such as:

• Electrocardiogram (ECG): This test measures the electrical activity of the heart and can detect arrhythmias or signs of inflammation.
• Echocardiogram: An ultrasound of the heart that provides detailed images and can identify structural abnormalities.
• Chest X-ray: This can help identify respiratory or musculoskeletal causes of chest pain.

Are you concerned about chest pain in your child? Arrange a consultation with Dr Wong via his Top Doctors profile.