Hostname: page-component-745bb68f8f-f46jp Total loading time: 0 Render date: 2025-02-05T22:40:34.239Z Has data issue: false hasContentIssue false
  • English
  • Français

Aetiological evaluation of chest pain in childhood and adolescence

Published online by Cambridge University Press:  05 May 2020

Emre Aygun Open the ORCID record for Emre Aygun [Opens in a new window] ,
Sibel Tugce Aygun ,
Taciser Uysal ,
Fatih Aygun ,
Hasan Dursun  and
Ahmet Irdem
Emre Aygun*
Affiliation:
Department of Pediatrics, Okmeydani Training and Research Hospital, Istanbul, Turkey
Sibel Tugce Aygun
Affiliation:
Department of Pediatrics, Okmeydani Training and Research Hospital, Istanbul, Turkey
Taciser Uysal
Affiliation:
Department of Child & Adolescent Psychiatry, Okmeydani Training and Research Hospital, Istanbul, Turkey
Fatih Aygun
Affiliation:
Department of Pediatrics, Okmeydani Training and Research Hospital, Istanbul, Turkey
Hasan Dursun
Affiliation:
Department of Pediatrics, Okmeydani Training and Research Hospital, Istanbul, Turkey
Ahmet Irdem
Affiliation:
Department of Pediatrics, Okmeydani Training and Research Hospital, Istanbul, Turkey
*
Author for correspondence: E. Aygun, Department of Pediatrics, Okmeydani Training and Research Hospital, Istanbul34384, Turkey. Tel: +90 5302071663; Fax: +90 0212 221 78 00. E-mail: emreaygun88@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Chest pain, as a common cause of hospital admissions in childhood, necessitates detailed investigations due to a wide range of differential diagnoses. In this study, we aimed to determine the distribution of diseases causing chest pain in children and investigate the clinical characteristics of children with chest pain.

Methods:

This study included 782 patients aged between 3 and 18 years who presented to a paediatric cardiology outpatient clinic with chest pain between April 2017 and March 2018. Aetiological causes and demographic features of the patients were analysed.

Results:

Most prevalent causes of chest pain were musculoskeletal system (33%) and psychogenic (28.4%) causes. Chest pain due to cardiac reasons was seen in eight patients (1%). Diseases of musculoskeletal and gastrointestinal systems and psychogenic disorders were significantly more common in male and female patients, respectively (p < 0.001 for all). In winter, patients’ age and the number of patients with ≥12 years were higher than those in other seasons (p < 0.001). Most of the parents (70.8%) and patients (90.2%) thought that chest pain in their children was caused by cardiac causes.

Conclusion:

Most of the diagnoses for chest pain in childhood period are benign and include the musculoskeletal system and psychogenic diseases. Although chest pain due to cardiac diseases is rare, a comprehensive analysis of medical history, detailed physical examination and cardiac imaging with echocardiography is needed to reach more accurate diagnoses.

Keywords

Childadolescentchest painnon-cardiacpsychogenic
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 5 , May 2020 , pp. 617 - 623
Copyright
© The Author(s) 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Blake, JM. A teen with chest pain. Pediatr Clin North Am 2014; 61: 17–28.CrossRefGoogle ScholarPubMed
Yeh, TK, Yeh, J. Chest pain in pediatrics. Pediatr Ann 2015; 44: e274–e278.CrossRefGoogle Scholar
Friedman, KG, Alexander, ME. Chest pain and syncope in children: a practical approach to the diagnosis of cardiac disease. J Pediatr 2013; 163: 896–901.CrossRefGoogle Scholar
Saleeb, SF, McLaughlin, SR, Graham, DA, Friedman, KG, Fulton, DR. Resource reduction in pediatric chest pain: standardized clinical assessment and management plan. Congenit Heart Dis 2018; 13: 46–51.CrossRefGoogle ScholarPubMed
Chun, JH, Kim, TH, Han, MY, Kim, NY, Yoon, KL. Analysis of clinical characteristics and causes of chest pain in children and adolescents. Korean J Pediatr 2015; 58: 440–445.CrossRefGoogle ScholarPubMed
Mohan, S, Nandi, D, Stephens, P, M’Farrej, M, Vogel, RL, Bonafide, CP. Implementation of a clinical pathway for chest pain in a pediatric emergency department. Pediatr Emerg Care 2018; 34: 778–782.CrossRefGoogle Scholar
Sert, A, Aypar, E, Odabas, D, Gokcen, C. Clinical characteristics and causes of chest pain in 380 children referred to a paediatric cardiology unit. Cardiol Young 2013; 23: 361–367.CrossRefGoogle ScholarPubMed
Gesuete, V, Fregolent, D, Contorno, S, Tamaro, G, Barbi, E, Cozzi, G. Follow-up study of patients admitted to the pediatric emergency department for chest pain. Eur J Pediatr 2019; 179: 303–308. doi: 10.1007/s00431-019-03495-5.CrossRefGoogle ScholarPubMed
Evangelista, JA, Parsons, M, Renneburg, AK. Chest pain in children: diagnosis through history and physical examination. J Pediatr Health Care 2000; 14: 3–8.CrossRefGoogle ScholarPubMed
Collins, SA, Griksaitis, MJ, Legg, JP. 15-minute consultation: a structured approach to the assessment of chest pain in a child. Arch Dis Child Educ Pract Ed 2014; 99: 122–126.CrossRefGoogle ScholarPubMed
Irak, M, Albayrak, EO. Psychometric properties of the expanded version of the inventory of depression and anxiety symptoms in a Turkish population. Psychol Rep 2018; 123:517–545. doi: 10.1177/0033294118813844CrossRefGoogle Scholar
Khairandish, Z, Jamali, L, Haghbin, S. Role of anxiety and depression in adolescents with chest pain referred to a cardiology clinic. Cardiol Young 2017; 27: 125–130.CrossRefGoogle ScholarPubMed
Drossner, DM, Hirsh, DA, Sturm, JJ, et al.Cardiac disease in pediatric patients presenting to a pediatric ED with chest pain. Am J Emerg Med 2011; 29: 632–638.CrossRefGoogle ScholarPubMed
Saleeb, SF, Li, WY, Warren, SZ, Lock, JE. Effectiveness of screening for life-threatening chest pain in children. Pediatrics 2011; 128: e1062–e1068.CrossRefGoogle ScholarPubMed
Cohn, HE, Arnold, LW. Chest pain in young patients in an office setting: cardiac diagnoses, outcomes, and test burden. Clin Pediatr (Phila) 2012; 51: 877–883.CrossRefGoogle Scholar
Friedman, KG, Kane, DA, Rathod, RH, et al.Management of pediatric chest pain using a standardized assessment and management plan. Pediatrics 2011; 128: 239–245.CrossRefGoogle ScholarPubMed
Lin, CH, Lin, WC, Ho, YJ, Chang, JS. Children with chest pain visiting the emergency department. Pediatr Neonatol 2008; 49: 26–29.CrossRefGoogle ScholarPubMed
Kane, DA, Friedman, KG, Fulton, DR, Geggel, RL, Saleeb, SF. Needles in Hay II: detecting cardiac pathology by the pediatric chest pain standardized clinical assessment and management plan. Congenit Heart Dis 2016; 11: 396–402.CrossRefGoogle ScholarPubMed
Kim, YJ, Shin, EJ, Kim, NS, Lee, YH, Nam, EW. The importance of esophageal and gastric diseases as causes of chest pain. Pediatr Gastroenterol Hepatol Nutr 2015; 18: 261–267.CrossRefGoogle ScholarPubMed
Hanson, CL, Hokanson, JS. Etiology of chest pain in children and adolescents referred to cardiology clinic. WMJ 2011; 110: 58–62.Google ScholarPubMed
Ruigómez, A, Rodríguez, LA, Wallander, MA, Johansson, S, Jones, R. Chest pain in general practice: incidence, comorbidity and mortality. Fam Pract 2006; 23: 167–174.CrossRefGoogle ScholarPubMed
Geggel, RL. Conditions leading to pediatric cardiology consultation in a tertiary academic hospital. Pediatrics 2004; 114: e409–e417.CrossRefGoogle Scholar
Perry, T, Zha, H, Oster, ME, Frias, PA, Braunstein, M. Utility of a clinical support tool for outpatient evaluation of pediatric chest pain. AMIA Annu Symp Proc 2012; 2012: 726–733.Google ScholarPubMed
Daşkapan, A, Şanlı, C, Aydoğan-Arslan, S, Çiledağ-Özdemir, F, Korkem, D, Kara, U. Evaluation of the functional capacity, respiratory functions and musculoskeletal systems of the children with chest pain for non-cardiac reasons. Turk J Pediatr 2017; 59: 295–303.CrossRefGoogle ScholarPubMed
Rowe, BH, Dulberg, CS, Peterson, RG, Vlad, P, Li, MM. Characteristics of children presenting with chest pain to a pediatric emergency department. CMAJ 1990; 143: 388–394.Google ScholarPubMed
Gumbiner, CH. Precordial catch syndrome. South Med J 2003; 96: 38–41.CrossRefGoogle ScholarPubMed
Eliacik, K, Kanik, A, Bolat, N, et al.Anxiety, depression, suicidal ideation, and stressful life events in non-cardiac adolescent chest pain: a comparative study about the hidden part of the iceberg. Cardiol Young 2017; 27: 1098–1103.CrossRefGoogle Scholar
McDonnell, CJ, White, KS, Grady, RM. Noncardiac chest pain in children and adolescents: a biopsychosocial conceptualization. Child Psychiatry Hum Dev 2012; 43: 1–26.CrossRefGoogle ScholarPubMed
Achiam-Montal, M, Tibi, L, Lipsitz, JD. Panic disorder in children and adolescents with noncardiac chest pain. Child Psychiatry Hum Dev 2013; 44: 742–750.CrossRefGoogle ScholarPubMed
Kenar, A, Örün, UA, Yoldaş, T, Kayalı, Ş, Bodur, Ş, Karademir, S. Anxiety, depression, and behavioural rating scales in children with non-cardiac chest pain. Cardiol Young 2019; 29: 1268–1271.CrossRefGoogle ScholarPubMed
Park, HW, Choi, YJ, Jeong, SJ. Screening and identifying erosive esophagitis in children with non-cardiac chest pain. J Korean Med Sci 2016; 31: 270–274.CrossRefGoogle ScholarPubMed
Achiam-Montal, M, Lipsitz, JD. Does parental response to children’s pain moderate the association between pain severity and functional disability? An examination of noncardiac chest pain. J Pediatr Psychol 2014; 39: 35–44.CrossRefGoogle ScholarPubMed