- by Dr Gowher Pebbles n Pearl Pediatrics and Child Care
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- Jun 05 2017
Does chest pain in children signal heart problem?
Children and teenagers who complain of chest pain only rarely have a heart problem causing it, a study published suggests. What's more, researchers say, relatively simple steps -- including a physical exam, family history and electrocardiogram -- could identify the kids who need more extensive, and expensive, testing for heart problems.
The study, reported in Pediatrics, looked at records for 3,700 children older than six who came to Children's Hospital Boston to have their chest pain evaluated. Just 1% had an underlying heart condition. The most common were inflammation of the heart muscle or pericardium, often the result of an infection; and supra-ventricular tachycardia. No child died of a cardiac cause during the 10-year study period.
"Chest pain in children is very common," she told Reuters Health, "but the chance of a cardiac cause is very low." Despite their rarity, sudden deaths from cardiac arrest are tragic and -- in the case of young athletes, in particular -- often garner media attention. So parents may become unduly alarmed by their children's chest pain, and kids may end up getting tests they don't need, according to Dr. Saleeb's team.
Often, chest pain in kids comes from something much milder than a heart condition. In many cases, though, the precise cause cannot be found, That was true of 52% of kids in this study. In the remaining patients, musculoskeletal causes were most common, followed by respiratory and gastrointestinal conditions, and, in 1%, anxiety.
Doctors use guidelines known as chest pain SCAMP (standardized clinical assessment and management plan). Children are first screened based on their symptoms, family history, a physical exam and an ECG. If there are concerns, they go on for further testing, usually with echocardiography.
Dr. Saleeb did point to some "red flags" that could suggest an underlying heart problem in kids -- including chest pain that arises specifically during exercise, or pain accompanied by other symptoms such as an arrhythmia or syncope.
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