Skip to main content
Log in

Chest Pain: Characteristics of Children/Adolescents

  • Original Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

Chest pain (CP) in children/adolescents is a common referral for the pediatric cardiologist. A group of 263 patients (141 males/122 females, mean age = 13.4 years, range = 5–22 years) with the primary complaint of CP underwent evaluation in the cardiac stress lab at Children’s Hospital of Wisconsin. Echocardiograms at rest were obtained in 70% of patients with no significant cardiac abnormalities identified. Endurance time (EXT) and oxygen consumption (VO2/kg) were below predicted in 26% and 46%, respectively. Reactive airway disease (RAD) as a preexisting condition was reported in 19% of patients, but abnormal resting pulmonary function (PFTs) were found in 26% (= 68), with 48/68 never having the diagnosis of RAD. At risk of overweight (BMI >85th percentile), was seen in 28% of the cohort, with 16% identified as being overweight (BMI >95th percentile). A significant difference in RAD (p < 0.01) was seen in African Americans (AA) and decreased EXT (p = 0.01) was seen in Hispanics (H). VO2/kg was significantly reduced in both AA and H (p < 0.01). These results identify both racial and age-related differences in the etiology of CP in children. Most importantly, true cardiac pathology is extremely rare. AOW, deconditioning, and respiratory compromise play important roles in CP. The need for comprehensive cardiopulmonary monitoring is emphasized by these findings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Brenner J, Ringel RE, Berman MA (1984) Cardiology perspectives of chest pain in childhood: a referral problem? To whom? Pediatr Clin North Am 31(6):1241–1258

    CAS  Google Scholar 

  2. Bruce RA (1971) Exercise testing of patients with coronary heart disease. Principles and normal standards for evaluation. Ann Clin Res 3:323–332

    PubMed  CAS  Google Scholar 

  3. Cummings GR, Hastman L (1978) Bruce treadmill protocol in children: normal values in a clinic population. Am J Cardiol 41:70–75

    Google Scholar 

  4. Evans R (1992) Asthma among minority children: a growing problem. Chest 101(6):368S–371S

    Article  PubMed  Google Scholar 

  5. Geggel RL (2004) Conditions leading to pediatric cardiology consultation in a tertiary academic hospital. Pediatrics 114:409–417

    Article  Google Scholar 

  6. Godfrey S (1974) Exercise testing in children. Sanders, London

    Google Scholar 

  7. Kocis KC (1999) Chest pain in pediatrics. Pediatr Clin North Am 46(2):189–203

    Article  PubMed  CAS  Google Scholar 

  8. Nudel DB, Diamant S, Brady T, Jarenwattananon M, Buckley BJ, Gootman N (1987) Chest pain, dyspnea, on exertion, and exercise induced asthma in children and adolescents. Clin Pediatr 26(8):388–392

    Article  CAS  Google Scholar 

  9. Polgar G, Promadhat V (1971) Standards in pulmonary function tests In: Polgar G (ed) Pulmonary function testing in children; techniques and standard. W.B. Saunders, Philadelphia, pp 254–260

    Google Scholar 

  10. Selbst SM (1990) Chest pain in children. Am Fam Physician 41(1):179–186

    PubMed  CAS  Google Scholar 

  11. Selbst SM, Ruddy RM, Clark BJ, Henretig FM, Santulli T (1988) Pediatric chest pain: a prospective study. Pediatrics 82(3):319–323

    PubMed  CAS  Google Scholar 

  12. Tunaoglu FS, Olgunturk R, Akcabay S, Oguz D, Gucuyener K, Demirsoy S (1995) Chest pain in children referred to a cardiology clinic. Pediatr Cardiol 16(2):69–72

    Article  PubMed  CAS  Google Scholar 

  13. United States Centers for Disease Control and Prevention (1998) Forecasted state-specific estimates of self-reported asthma prevalence. Morbid Mortal 47(47):1022–1025

    Google Scholar 

  14. United States Centers for Disease Control (1998) Surveillance for asthma—United States, 1960–1995. Morbid Mortal 47:SS-1

    Google Scholar 

  15. Wiens L, Sabbetha R, Ewing L, Gowdamarajan R, Portnoy J, Scagliotti D (1992) Chest pain in otherwise healthy children and adolescents is frequently caused by exercise induced asthma. Pediatrics 90(3) 350–353

    PubMed  CAS  Google Scholar 

  16. Williams CL, Hayman LL, Daniels SR et al (2002) Cardiovascular health in childhood: a statement for health professionals from the committee on atherosclerosis, hypertension, and obesity in the young (AHOY) of the Council on Cardiovascular Disease in the Young, American heart association. Circulation 106:143–160

    Article  PubMed  Google Scholar 

  17. Zavaras-Angelidou KA, Weinhouse E, Nelson DB (1992) Review of 180 episodes of chest pain in 134 children. Pediatr Emerg Care 8(4):189–193

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael J. Danduran.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Danduran, M.J., Earing, M.G., Sheridan, D.C. et al. Chest Pain: Characteristics of Children/Adolescents. Pediatr Cardiol 29, 775–781 (2008). https://doi.org/10.1007/s00246-008-9200-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-008-9200-9

Keywords

Navigation