Chest Pain in Pediatrics, Local Center Experience

Abstract

Background: Chest pain in children might cause anxiety for the patient and his/her family. It was reported that a follow up of chest pain in pediatrics doesn't increase the risk of sudden cardiac death. Materials and methods: A retrospective review of all pediatric cases referred with a complaint of chest pain to pediatric cardiology-PSCC-Qassim since 2006. Families were contacted to review the child condition and the status of the chest pain complaint and any medical problems the child might have. Results: A total of 242 pediatric cases were referred with a complaint of chest pain since 2006. 135 (56%) were females. The age & weight at referral was 2 to 14 years and 5 to 71 kg. 16 (6.7%) patients reported that there is a relation between chest pain and exercise. The most frequent associated symptom was palpitations. Clinically 50 cases (20.6%) had cardiac murmurs with normal general, cardiac and other organ systems exam. 12 patients had minor ECG abnormalities (PACs, PVCs, borderline long QT). 23 patients (9.5%) had abnormal echo findings in the form of BAV, ASD, PFO, MVP, and PAPVD. By Telephone contact of the families, the current age of those referred is 4 to 22 years (average 12.8 +/- 3.3 years). 195 families (80.6%) reported that their children have no more chest pain. 48 children (19.8%) reported that they are still having nonspecific chest pain which didn't interfere with the child living conditions. 13 children (5.4%) have medical problems (e.g. bronchial asthma, anemia, hyperthyroidism, etc. ). All are alive with no reported cardiac events. Conclusion: Chest pain in pediatrics is a benign condition. A proper assessment will decrease referrals and the use of extensive investigations. It is less likely to affect the child daily activities and doesn’t increase the risk of sudden cardiac death.