Chest Pain in Children: What You Need to Know


If your child experiences chest pain, you may be wondering about the cause. While it could be an issue related to your child’s heart, it’s more likely another cause, such as a respiratory, muscle, bone joint, gastrointestinal, or mental health condition.

Often, chest pain will go away on its own, but it’s helpful to know what types of conditions can lead to chest pain so you can decide whether to contact your child’s doctor.

Here are some reasons a child may have chest pain.

Chest pain is often unrelated to the heart, but you shouldn’t immediately rule it out. A study published in 2010 stated that only 2 percent of visits to the doctor for children and adolescents citing chest pain were related to a heart condition.

Less than 2 percent of chest pain in children is related to a heart condition.

Your child’s chest pain may be related to the heart if it’s accompanied by pain that radiates to the neck, shoulder, arm, or back.

It may also be associated with the heart if your child experiences dizziness or fainting, a changing pulse or blood pressure, or has had a diagnosis of a previous cardiac condition.

Here are some specific heart conditions associated with chest pain in children.

Coronary artery disease

Your child may experience chest pain associated with coronary artery disease. They may have other symptoms like tightness or pressure in the chest with this condition.

Coronary artery disease may appear after your child is engaged in a physical activity. Prior heart surgeries, transplants, and conditions such as Kawasaki disease are associated with coronary artery conditions in children.

Myocarditis and pericarditis

These heart conditions can occur from a viral or bacterial infection. Myocarditis may occur after your child has been sick with a viral infection. Other symptoms include shortness of breath, dizziness, and fainting.

Pericarditis can cause sharp chest pain that continues to the left shoulder. It can get worse if you cough, breathe deeply, or lie on your back.

Congenital anomalies of the heart

Congenital conditions related to the heart are often diagnosed early in your child’s life. These conditions occur because a part of the heart didn’t develop correctly before birth while in utero.

Congenital heart conditions can vary widely and have many different symptoms.

The following congenital heart conditions may cause chest pain:

It’s more likely that chest pain is related to a condition other than the heart, such as a respiratory condition.

Asthma

Asthma may be the cause of your child’s chest pain. Symptoms of asthma other than chest pain include shortness of breath, wheezing, and coughing.

Asthma should be treated with both preventive and rescue medications. Your child should avoid environments and substances that trigger asthma.

Respiratory infections

Your child’s chest pain may be associated with infections that settle in the respiratory system. These can include infectious bronchitis and pneumonia, among others.

Your child may experience a fever, low energy, a cough, and other symptoms with these conditions.

Pulmonary embolism

pulmonary embolism occurs when a blood clot forms in the arteries of the lungs and gets in the way of normal blood flow.

Your child may be more susceptible to this condition if they’re immobile for a period of time, if they have cancer or diabetes mellitus, or if there’s a family history of the condition.

They may be short of breath or breathe fast, have a blue color on their fingers and lips, and cough up blood. This condition requires medical treatment.

Your child’s chest pain may be the result of a condition related to the bones or muscles in the chest.

Most of the time, the pain from these conditions can often be identified in a specific place and can occur predictably with repeated movements.

Contusions

Your child’s chest pain may be the result of trauma. They may have a contusion, also called a bruise, below the skin caused by an accident like a collision or fall.

Contusions may heal on their own with time and ice applications a few times a day. Pain-relieving medication may also be helpful to your child.

Muscle strain

Your active child may have strained a muscle, leading to chest pain. This may occur if your child lifts weights or plays sports. The pain will occur in a specific area of the chest and feel tender. It may also be swollen or red.

Costochondritis

Costochondritis occurs in the upper half of your ribs in the area of cartilage that connects your ribs to your sternum. This is the location of your costochondral joints.

Your child may experience sharp pain in these joints, two or more adjacent, that gets worse with deep breaths or when the affected area is touched. This is because of inflammation, but there isn’t noticeable warmth or swelling over the affected area upon examination.

The pain may last a few seconds or longer. The condition should go away over time.

Tietze syndrome

Tietze syndrome is also the result of inflammation in the joints of the upper rib. It usually occurs in one joint, and the inflammation causes noticeable warmth and swelling over the affected joint.

Your child may think the chest pain from this condition is a heart attack. This condition may develop because of a severe cough or physical activity that strains the chest.

Slipping rib syndrome

This condition doesn’t occur often in children, but it can be the source of chest pain.

Pain from slipping rib syndrome will occur in the lower part of the rib cage, and it may be painful and then ache after the pain dulls. This discomfort occurs because the rib may slip and press on a nearby nerve.

Precordial catch (Texidor’s twinge)

Precordial catch causes chest pain that’s dramatic and severe for a short moment on the left side near the bottom of the sternum.

Your child may experience this pain when standing up straight from a slouching position. The cause of precordial catch may be a pinched nerve or muscle strain.

Chest wall pain

Chest wall pain is common in children. It causes sharp pain for a short moment or a few minutes in the middle of the chest. It can become worse if your child breathes deeply or if someone presses on the middle of the chest.

Xiphodynia

Xiphodynia can cause pain at the bottom of the sternum. Your child may experience it after eating a large amount of food, moving around, or coughing.

Pectus excavatum

This occurs when the sternum is sunken inward. Chest pain and other symptoms can occur because the sunken-in chest doesn’t provide enough room for your child’s heart and lungs to work properly.

Scoliosis

Scoliosis bends the spine curvature outward to one side or the other and can cause compression on your child’s spinal cord and other nerves. It can also distort the proper size of the chest cavity. This can feel like chest pain.

Your child will need treatment for scoliosis because it can inhibit their movements and lead to other health conditions.

Your child’s chest pain may be caused by gastrointestinal distress, such as gastroesophageal reflux disease (GERD).

GERD can cause a burning sensation in the chest and may worsen after your child eats a large meal or lies down for rest. Your child may need to modify their diet or take medication to reduce GERD symptoms like chest pain.

Other gastrointestinal and digestive system conditions, such as peptic ulcers, spasms or inflammation in the esophagus, or inflammation or stones in the gallbladder or biliary tree, could cause chest pain as well.

Chest pain in your child may be the result of a mental health condition. Anxiety can cause your child to hyperventilate. This is associated with chest pain and symptoms like trouble breathing and dizziness. Stress may also trigger unexplained chest pain.

Children going through puberty may experience chest pain related to their breasts as their hormone levels change. This pain can affect both girls and boys.

Your child’s chest pain can be very concerning, and some symptoms should prompt an immediate call to your doctor. These include:

CALL THE DOCTOR

If your child experiences any of these symptoms, call the doctor.

  • pain that occurs after exercise
  • pain that lasts a long time and is severe
  • pain that is recurring and worsening
  • pain that occurs with fever
  • a racing heart
  • dizziness
  • fainting
  • difficulty breathing
  • blue or gray lips

There are many reasons your child may experience chest pain. Many of the causes of chest pain aren’t long-lasting or life-threatening.

Some conditions are more serious and should be diagnosed by your doctor. Seek emergency medical care if other serious symptoms occur with your child’s chest pain.

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