Chest Pain

ABSTRACT

Chest pain in children is a common complaint;however, it is rarely due to underlying cardiac illness. This underscores the importance of avoiding a false sense of safety in low-risk causes and maintaining vigilance for potential life-threatening etiologies. Taking into account age of the child and level of family anxiety (often due to adult family members with significant cardiac illness) and a stepwise approach are essential in evaluation of this symptom. Broad etiologies of chest pain include idiopathic, musculoskeletal, psychologic, gastrointestinal, pulmonary, and cardiac. Specific questions targeted at red flag symptoms can assist providers in ensuring that risk factors for cardiac arrest are assessed. COVID-19 and multisystem inflammatory syndrome in children (MIS-C) are newer causes of chest pain to be aware of. However, the cause of a complaint can be multifactorial and a thoughtful history, physical examination, and targeted work-up as needed are of utmost importance.