Children with Chest Pain Presenting to a Pediatric Cardiology Service or Emergency Department in an Academic Centre

Aim: To assess the etiology of chest pain among children referred to an emergency department or to a cardiology clinic Method: All echocardiograms performed on 50 consecutive children (27 girls, 23 boys) (aged 1.8 -16 years) who were referred to pediatric cardiology services for evaluation of chest pain in two years were reviewed. One pediatric cardiologist reviewed the patient records and echocardiograms. All cases had 6 months follow up. Result: Analysis of the history showed that 71% of patients had chest pain only, 17 % had chest pain with heart disease, and 1 % had chest pain related to miscellaneous causes. Causes of chest pain were: chest-wall pain (CW) (67%), and pulmonary (17%), psychological (3%), cardiac (14 %), traumatic (5%), and gastrointestinal problems (4%). The most common physical finding was chest tenderness (41% of cases). Investigations included echocardiogram (86%), chest radiography (50%), electrocardiography (46 %) and determination of the hemoglobin concentration and of the leukocyte count (14%); the results were rarely positive. Two patients required admission to hospital; there were no cases of myocardial ischemia. Conclusion: Chest pain is an uncommon and usually benign complaint in the pediatric population. Most causes are evident on careful physical examination.