Chest pain is an alarming symptom causing anxiety in our patients and their family. There are over 70 different reasons for chest pain, including chest muscle soreness, intestinal gas, asthma, coughing, reflux, anxiety, stress, trauma, heartburn, costochondritis, pleurisy, pneumonia, palpitations, and many others. Over 15% of patients have an unidentifiable cause. Chest pain in an otherwise healthy patient is usually benign. Over 95% of young patients referred for chest pain have what we call benign or “no big deal” chest discomfort.
Dr. Villafañe collected data on several hundred pediatric patients referred to us with the chief complaint of chest pain. Most of the patients complained of localized pain at the mid part of their chest or “chest bone” while others complain of chest pain on the left side of their chest. They usually describe the pain as a sharp or stabbing pain while others complain of needle sticks, pressure or heavy weight on their chest. Over half of them feel that their heart was pounding and beating faster than usual.
Most patients and their families are worried that the pain may cause a heart attack or be a serious heart condition. In many patients there is positive family history of heart problems. Fortunately, the cause for chest pain in the young population is quite different from older adults. The good news is that the vast majority (97%) of these patients have nothing to worry about and, although the symptoms may last on-and-off for several months, they usually fade away. This is why some people call them “growing pains.”
Only a small percentage (about 3%) of patients with chest pain may have an underlying heart condition. This may include mitral valve prolapse, cardiomyopathy, pericarditis, aortic stenosis, coronary abnormalities, aortic dissection and tachyarrhythmias. Heart attacks are a very rare event in young patients.
Many patients may complain of pain or tenderness when they are touched around the “chest bone.” This usually tends to indicate that there is muscle soreness or a mild local inflammation that may respond to analgesics.