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Role of anxiety and depression in adolescents with chest pain referred to a cardiology clinic

Published online by Cambridge University Press:  16 March 2016

Zahra Khairandish ,
Leila Jamali  and
Saeedeh Haghbin Open the ORCID record for Saeedeh Haghbin [Opens in a new window]
Zahra Khairandish
Affiliation:
Department of Pediatrics, Division of Cardiology, Faculty of Medicine, Islamic Azad University – Kazerun Branch, Kazerun, Iran
Leila Jamali
Affiliation:
Department of Pediatrics, Division of Cardiology, Faculty of Medicine, Islamic Azad University – Kazerun Branch, Kazerun, Iran
Saeedeh Haghbin*
Affiliation:
Department of Pediatrics, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
*
Correspondence to: S. Haghbin, MD, Department of Pediatrics, Namazi Hospital, Motaharri Avenue, Zand Blvd, Shiraz 71937-11351, Iran. Tel and Fax: +98 713 647 4298; E-mail: haghbins@sums.ac.ir
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Abstract

Background

We carried out this study in order to evaluate the causes of chest pain in teenagers and the role of anxiety and depression in this age group compared with the normal population.

Methods

In this prospective case–control study, all patients aged 11–18 years with chest pain and no history of trauma and referred to a paediatric cardiology clinic from March, 2009–April, 2010 were selected. A chest pain protocol including a detailed history, full physical examination, required blood tests, electrocardiography, and echocardiography was performed for all. The presence of depression and anxiety and their severity were assessed by Beck questionnaires. The patients were compared with age- and sex-matched, randomly selected healthy controls.

Results

In total, 194 patients with a mean age of 14±2 years were selected. The most frequent presentation was idiopathic chest pain (43.3%), followed by the psychological group (29.9%). These groups had no abnormal points in history, physical, and para-clinical tests. Moderate-to-severe depression was found in 45.9% in the patients group, compared with 17.6% of controls, which was statistically significant (p=0.016). Moreover, anxiety was detected in 67.5% of patients versus 15.4% in controls, which is a statistically significant difference (p=0.009). Cardiac chest pain with 9.27% was the most common type of organic causes.

Conclusion

Chest pain during teenage is more prevalent, but not risky. Undergoing a detailed history and full physical examination can help diagnose the causes in the majority of cases. Given the prevalence of a psychological group as well as role of anxiety and depression in most patients, referring to a psychiatrist is suggested.

Keywords

Chest paindepressionanxietycardiacpsychological
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 1 , January 2017 , pp. 125 - 130
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Copyright
© Cambridge University Press 2016 

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References

1. Brenner, JI, Ringel, RE, Berman, MA. Cardiologic perspectives of chest pain in childhood: a referral problem? To whom? Pediatr Clin North Am 1984; 31: 1241–1258.CrossRefGoogle ScholarPubMed
2. Fyfe, DA, Moodie, DS. Chest pain in pediatric patients presenting to a cardiac clinic. Clin Pediatr (Phila) 1984; 23: 321–324.CrossRefGoogle ScholarPubMed
3. Selbst, SM. Chest pain in children. Pediatrics 1985; 75: 1068–1070.CrossRefGoogle ScholarPubMed
4. Lane, J, Ben-Shachar, G. Myocardial infarction in healthy adolescents. Pediatrics 2007; 120: 938–943.CrossRefGoogle ScholarPubMed
5. Smith, MS. Psychosomatic symptoms in adolescence. Med Clin North Am 1990; 74: 1121–1134.CrossRefGoogle ScholarPubMed
6. Coleman, WL. Recurrent chest pain in children. Pediatr Clin North Am 1984; 31: 1007–1026.Google Scholar
7. Anzai, AK, Merkin, TE. Adolescent chest pain. Am Fam Physician 1996; 53: 1682–1688.Google ScholarPubMed
8. Selbst, SM. Consultation with the specialist. Chest pain in children. Pediatr Rev 1997; 18: 169–173.CrossRefGoogle ScholarPubMed
9. Proulx, AM., Zryd, TW. Costochondritis: diagnosis and treatment. Am Fam Physician 2009; 80: 617–620.Google ScholarPubMed
10. Kocis, KC. Chest pain in pediatrics. Pediatr Clin North Am 1999; 46: 189–203.Google Scholar
11. Sabri, MR, Ghavanini, AA, Haghighat, M, et al. Chest pain in children and adolescent: epigastric tendernes as a guide to reduce unnecesarry work-up. Pediatr Cardiol 2003; 24: 3–5.Google Scholar
12. Wang, TL, Peng, KR, Jiang, MZ, et al. Noncardiac chest pain and gastroesophageal reflux in children. Zhonghua Jie He He Hu Xi Za Zhi 2006; 29: 563–566.Google ScholarPubMed
13. Kalpatthi, R, Kane, ID, Shatat, IF, et al. Clinical events after surgical splenectomy in children with sickle cell anemia. Pediatr Surg Int 2010; 26: 495–500.Google Scholar
14. Reagan, MM, DeBaun, MR, Frei-Jones, MJ. Multi-modal intervention for the inpatient management of sickle cell pain significantly decreases the rate of acute chest syndrome. Pediatr Blood Cancer 2011; 56: 262–266.CrossRefGoogle ScholarPubMed
15. Woolf, PK, Gewitz, MH, Berezin, S, et al. Noncardiac chest pain in adolescent and children with mitral valve prolapsed. J Adolesc Health 1991; 12: 247–250.Google Scholar
16. Nezu, AM, Nezu, CM, Jain, D, et al. Social problem solving and noncardiac chest pain. Psychosom Med 2007; 69: 944–951.CrossRefGoogle ScholarPubMed
17. Gilleland, J, Blount, RL, Campbell, RM, et al. Brief report: psychosocial factors and pediatric noncardiac chest pain. J Pediatr Psychol 2009; 34: 1170–1174.CrossRefGoogle ScholarPubMed
18. Waller, A, Hakenewerth, A, Tintinalli, J, et al. North Carolina Emergency Department data: January 1, 2007-December 31, 2007. N C Med J 2010; 71: 15–25.Google Scholar
19. Evangelista, JA, Parsons, M, Renneburg, AK. Chest pain in children: diagnosis through history and physical examination. J Pediatr Health Care 2000; 14: 3–8.Google Scholar
20. Selbst, SM, Ruddy, RM, Clark, BJ, et al. Pediatric chest pain: a prospective study. Pediatrics 1988; 82: 319–323.Google Scholar
21. Reddy, SR, Singh, HR. Chest pain in children and adolescents. Pediatr Rev 2010; 31: e1–e9.Google Scholar
22. Thull-Freedman, J. Evaluation of chest pain in the pediatric patient. Med Clin North Am 2010; 94: 327–347.CrossRefGoogle ScholarPubMed
23. Danduran, MJ, Earing, MG, Sheridan, DC, et al. Chest pain: characteristics of children/adolescents. Pediatr Cardiol 2008; 29: 775–781.Google Scholar
24. Cağdaş, DN, Paç, FA. Cardiac chest pain in children. Anadolu Kardiyol Derg 2009; 9: 401–406.Google Scholar
25. Tunaoglu, FS, Olguntürk, R, Akcabay, S, et al. Chest pain in children referred to a cardiology clinic. Pediatr Cardiol 1995; 16: 69–72.Google Scholar
26. Gomez-Caminero, A, Blumentals, WA, Russo, LJ, et al. Does panic disorder increase the risk of coronary heart disease? A cohort study of a national managed care database. Psychosom Med 2005; 67: 688–691.Google Scholar
27. Cheng, C, Wong, WM, Lai, KC, et al. Psychosocial factors in patients with noncardiac chest pain. Psychosom Med 2003; 65: 443–449.CrossRefGoogle ScholarPubMed
28. Gilleland, J, Blount, RL, Campbell, RM, et al. Brief report: psychosocial factors and pediatric noncardiac chest pain. J Pediatr Psychol 2009; 34: 1170–1174.CrossRefGoogle ScholarPubMed
29. Ives, A, Daubeney, PE, Balfour-Lynn, IM. Recurrent chest pain in the well child. Arch Dis Child 2010; 95: 649–654.CrossRefGoogle ScholarPubMed
30. Lipsitz, JD, Masia-Warner, C, Apfel, H, et al. Anxiety and depressive symptoms and anxiety sensitivity in youngsters with noncardiac chest pain and benign heart murmurs. J Pediatr Psychol 2004; 29: 607–612.Google Scholar
31. Lipsitz, JD, Gur, M, Sonnet, FM, et al. Psychopathology and disability in children with unexplained chest pain presenting to the pediatric emergency department. Pediatr Emerg Care 2010; 26: 830–836.Google Scholar