Patient
Information
Chest Pain in Children and
Adolescents
Chest pain is very common in children and teenagers and,
happily, is only rarely associated with heart problems. Children
frequently have pain because of muscle strain or injury or, very
commonly, spasm in the muscles of the chest. This sort of chest
pain usually feels sharp or jabbing, lasts less than a minute, and
can occur during exercise or at rest. Chest pain from muscle spasm
often is made worse by taking a deep breath, moving a particular
way or pressing on the area. It is not associated with difficulty
breathing, dizziness, fainting, or a feeling of a racing
heartbeat. Some people, particularly young women, can develop
inflammation in the joints that connect the ribs to the sides of
the breast bone (costochondritis), causing pain in this area.
Other types of non-cardiac chest pain include "growing
pains", a dull aching pain localized around the center of the
chest. Eating too quickly, or eating cold food or food that can
get stuck in the esophagus (tube connecting the mouth to the
stomach) can cause esophageal spasm, a squeezing pain in the
center of the chest that is made worse by swallowing. Heartburn,
caused by stomach contents washing up the esophagus can also feel
like pain in the chest, particularly to children. Also, problems
with the lungs and windpipe can cause chest pain. Infections of
the lining of the lungs can cause fever and pain with breathing
(pleurisy). Smoking or infections can cause coughing and pain in
the windpipe (trachiitis). Children with asthma or other lung
problems seem to have more problems with chest wall muscle spasm,
and can also have other chest pains of a more vague nature.
Chest pain associated with exercise merits special evaluation
to rule out medical problems such as coronary artery problems,
abnormal heart rhythms or inflammation of the heart. Still,
chest pain with exercise most often represent chest wall muscle
spasm, heart burn (reflux), exercise-induced asthma or
overexertion. Often young women may experience improvement in
chest pain of this sort by switching to a very supportive
well-fitting sports bra, ideally one featuring underwire support,
wide adjustable straps and an adjustable back (one resource in
this regard can be found at www.x-chrom.com/braguide.php4). My
female colleagues recommend the Champion Action Shape and Champion
Double Dry Body Bra.
Chest pain due to overexertion may be caused by fatigue and
ischemia of the respiratory muscles in the chest wall as a sign of
overexertion. While not a dangerous condition, this sort of
symptom should reasonably be considered a sign that one has
reached one's physical limit.
Only a small percentage of children with chest pain turn out to
have a serious problem, but warning signs that should prompt
immediate evaluation by a physician include chest pain associated
with any of the below:
- Genuine shortness of breath or difficulty breathing (not
just painful breathing)
- Fever
- Paleness and sweating
- Dizziness or fainting
- Palpitations (the sensation of a fast or irregular heart
beat)
- Severe or prolonged pain
- Known heart problems
- A family history of heart disease or sudden death
For more information about chest pain on the web, have a look
around some these sites:
Cincinnati Children's Hospital:
Chest Pain
Pennsylvania Children's Hospital:
Chest Pain
About.com
SchoolNurse.com
|
