Don’t panic if your child has chest pain, seek a specialist instead
The reasons for chest pain may vary. It could be acid reflux or even a simple case of stress and anxiety due to school examinations”
Dr Samah Alasrawi, pediatric cardiologist
It is very common to see parents rushing into our Emergency Department disturbed and worried when their child complains of chest pain. This can be a source of significant anxiety, both for the child as well as parents. Fortunately, most chest pains in children are caused by benign or self-limited, non-cardiac illnesses. In fact, 98 per cent of all cases are for reasons not related to cardiac causes. Any structure within the chest such as ribs, lungs, diaphragm, chest wall muscles and joints can cause pain.
The reasons for this may vary and can be attributed to chest muscles, acid reflux, infection or irritation of the lungs, or even a simple case of stress and anxiety due to school examinations.
As cardiologists, we conduct several investigations to rule out cardiac causes. These include resting electrocardiogram (ECG) to rule out any heart arrhythmia, echocardiogram to evaluate structures, function and coronary arteries, and exercise ECG to assess the development of arrhythmia or ischemia during exertion. Other tests may include chest X-rays to evaluate lungs, ribs and heart shadow or performing lab tests in patients with suspected lung infections.
With that being said, what are the real red flags? Parents should consider visiting a cardiologist when their child has exertional chest pain, chest pain with brief loss of consciousness, chest pain with palpitations, or if the family has any history of heart diseases, cardiac surgery or interventions.
The cardiac causes of chest pain in children may include pericarditis, which is an inflammation of the sac surrounding the heart; abnormalities in coronary arteries that transport oxygenated blood to the substance of the heart; Kawasaki Disease, which causes dilatations of the coronary arteries; and Hypertrophic Cardiomyopathy, an abnormal thickening of the heart or abnormal heart rhythms.
It may be difficult to prevent chest pain, but parents can ease the condition by making sure their kids receive routine immunisations to prevent infections, follow a doctor’s treatment plan if the child has asthma with regular check-ups, and avoid foods that seem to bring on indigestion. In addition, parents have to make sure that kids undergo a physical examination before playing organised sports, especially competitive ones.
The bottom line is that parents should not panic when their child
complains of chest pain. Head to your paediatrician and do the required tests. There is a high probability that what your child needs is just a bit more of your attention.