Chest pain (peds): Difference between revisions
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*Pulmonary | *Pulmonary | ||
**[[Pneumothorax]] | **[[Pneumothorax]] | ||
**[[Pneumonia (Peds)]] | |||
**[[Pulmonary embolism]] | |||
**[[Aortic dissection]] | |||
***Uncommon but consider with history of [[connective tissue disease]] | |||
*GI | *GI | ||
**[[Esophagitis]] | **[[Esophagitis]] | ||
**[[Esophageal spasm]] | |||
**[[Gastritis]] | |||
*Psychosomatic | *Psychosomatic | ||
**[[Panic attack]] | |||
**[[Anxiety]] | |||
*Cardiac (1%) | *Cardiac (1%) | ||
**Left-sided obstructive lesions | **Left-sided obstructive lesions | ||
| Line 32: | Line 40: | ||
**[[MI]] | **[[MI]] | ||
***Rare, even post-[[Kawasaki]] | ***Rare, even post-[[Kawasaki]] | ||
***Consider [[SCAD]] | |||
**[[Mitral valve prolapse]] | **[[Mitral valve prolapse]] | ||
Revision as of 15:58, 4 August 2020
This page is for pediatric patients. For adult patients, see: chest pain
Background
- Common cause of presentation to the ED, especially in adolescents
- The majority of pediatric chest pain is benign and not cardiac in origin
- The main cause of cardiac chest pain in pediatrics is pericarditis
- Family history plays an important part screening for familial history of sudden death
Clinical Features
- Chest pain
- Physical exam
- Listen for murmurs
- Palpate
- Compress rib cage
Differential Diagnosis
- Idiopathic (most common)
- Precordial catch syndrome
- Sudden, intense pain with deep inspiration, self-resolving
- Musculoskeletal
- Pulmonary
- Pneumothorax
- Pneumonia (Peds)
- Pulmonary embolism
- Aortic dissection
- Uncommon but consider with history of connective tissue disease
- GI
- Psychosomatic
- Cardiac (1%)
- Left-sided obstructive lesions
- Dysrhythmias
- HOCM
- Pericarditis
- Prinzmetal's angina (vasospasm)
- MI
- Mitral valve prolapse
Evaluation
- ECG
- CXR
- Consider echocardiography