It is common to worry when your child complains of chest pain. In fact, chest pain is the second most common reason for visits to pediatric cardiologists after cardiac murmurs.

Most cases of chest pain in this age group are benign and are rarely caused by cardiovascular diseases. The main causes of chest pain may likely be due to medical conditions involving other organs, such as the lungs, bones, muscles, stomach or other parts of the body.

Although chest pain goes away on its own, it is important to recognize and diagnose life-threatening diseases that may manifest as chest pain in children and adolescents. Here are some of the causes of chest pain in children that can be helpful when deciding to seek medical consultation.

Heart Conditions

Chest pain among children may be associated with a heart condition when it is accompanied by one or a combination of the following symptoms:

• Pain that radiates to the neck, shoulder, arm or back
• Dizziness
• Fainting
• Irregular pulse or blood pressure
• Previous diagnosis of a cardiac condition

Some of the cardiovascular diseases associated with chest pain that can affect children are as follows:

• Congenital Heart Disease
  A type of heart disease that children are born with that is usually caused by heart defects present at birth.
• Arrythmias
  Refers to an abnormal rhythm of the heart that causes the heart to pump less efficiently.
• Heart Murmurs
  The “whooshing” sound in between heartbeats produced when the blood circulates through the heart’s chambers or valves or through blood vessels near the heart.
• Myocarditis
  The inflammation of the heart muscle in an infant or young child due to a viral or bacterial infection.
• Rheumatic Heart Disease
  This starts as a sore throat infection caused by the streptococcus bacteria that can pass easily from person to person.
• Respiratory Conditions
  While chest pain seems related to heart problems, it is more likely that another condition, such as a respiratory condition may be causing this symptom.
• Asthma
  Asthma is a respiratory condition that causes airways in the lungs to get swollen, smaller and filled with mucus that can lead to breathing problems.
• Bronchitis
  Bronchitis is when the lining of these airways turn red or get swollen, making hard for air to pass in and out of the lungs.
• Pneumonia
  Pneumonia is a form of acute respiratory infection that affects one or both lungs.
• Pulmonary Embolism
  This condition occurs when a blood clot forms in the arteries of the lungs and gets in the way of normal blood flow.

Musculoskeletal Conditions

Chest pain may be the result of a condition associated with the bones or muscles in the chest in some cases. The pain can often be identified in a specific place and can occur predictably with repeated movements. Some of these conditions include the following:

• Contusions
  Sometimes a child’s chest pain may be the result of trauma, such as a contusion or bruise from a collision or fall.
• Costochondritis
  This is due to the painful swelling of the cartilage that attaches the ribs to the breastbone.
• Precordial Catch (Texidor’s Twinge)
  A harmless and sudden chest pain that occurs when the nerves in the front of the chest are squeezed or aggravated that lasts a few minutes at most.

When to Seek Medical Help

Early diagnosis is key in detecting life-threatening diseases requiring prompt treatment. If your child experiences any of the symptoms below, do not delay care. Seek medical attention immediately or call 911.

• Severe and recurring pain
• Pain with fever
• A racing heartbeat
• Dizziness
• Fainting
• Shortness of breath
• Blue or gray lips

Sources:
World Health Organization
Centers for Disease Control and Prevention
National Center for Biotechnology Information
Healthline
MedlinePlus
KidsHealth