Chest pain (peds) - Revision history

Danbot: Add verified PubMed references (PMIDs 21541647, 38473000)

2026-03-22T10:59:07Z

Add verified PubMed references (PMIDs 21541647, 38473000)

← Revisión anterior		Revisión del 10:59 22 mar 2026
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	{{PediatricPage\|chest pain}}		{{PediatricPage\|chest pain}}
	==Background==		==Background==
	*Common cause of presentation to the ED, especially in adolescents		*Common cause of presentation to the ED, especially in adolescents<ref>Jindal A, Singhi S. Acute chest pain. Indian J Pediatr. 2011 Oct;78(10):1262-7. PMID 21541647</ref>
	*The vast majority (>95%) of pediatric chest pain is benign and non-cardiac in origin		*The vast majority (>95%) of pediatric chest pain is benign and non-cardiac in origin
	*Most common causes are musculoskeletal (costochondritis, muscle strain), idiopathic, and respiratory		*Most common causes are musculoskeletal (costochondritis, muscle strain), idiopathic, and respiratory<ref>Huang SW, Liu YK. Pediatric Chest Pain: A Review of Diagnostic Tools in the Pediatric Emergency Department. Diagnostics (Basel). 2024 Mar 1;14(5). PMID 38473000</ref>
	*Cardiac causes are rare but must be identified: [[pericarditis]], [[myocarditis]], arrhythmias, coronary anomalies		*Cardiac causes are rare but must be identified: [[pericarditis]], [[myocarditis]], arrhythmias, coronary anomalies
	*Family history plays an important part screening for familial history of sudden death, [[hypertrophic cardiomyopathy]], [[long QT syndrome]], or [[Marfan syndrome]]		*Family history plays an important part screening for familial history of sudden death, [[hypertrophic cardiomyopathy]], [[long QT syndrome]], or [[Marfan syndrome]]

2026-03-20T23:24:24Z

Expanded with EM-focused content: red flags, risk stratification, evaluation strategy, management, disposition

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 ==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 vast majority (>95%) of pediatric chest pain is benign and non-cardiac in origin
-*The main cause of cardiac chest pain in pediatrics is [[pericarditis]]
+*Most common causes are musculoskeletal (costochondritis, muscle strain), idiopathic, and respiratory
-*Family history plays an important part screening for familial history of sudden death
+*Cardiac causes are rare but must be identified: [[pericarditis]], [[myocarditis]], arrhythmias, coronary anomalies
 ==Clinical Features==
-*[[Chest pain]]
+===History===
-*Physical exam
+*Onset, location, duration, character, radiation, exertional vs. rest
-**Listen for murmurs
+*Reproducibility with palpation (suggests musculoskeletal)
-**Palpate
+*Associated symptoms: fever, dyspnea, palpitations, syncope, cough, anxiety
-**Compress rib cage
+*Recent illness, trauma, or strenuous activity
 ==Differential Diagnosis==
@@ Línea 17: / Línea 36: @@
 ==Evaluation==
-*[[ECG]]
+===Low Risk (Typical Musculoskeletal)===
-*[[CXR]]
+*Reproducible chest wall tenderness, no red flags
-*Consider [[echocardiography]]
+*No further workup generally needed
 ==Management==
 ==Disposition==
 ==See Also==
 *[[Chest pain]]
 ==External Links==

2026-01-17T17:07:09Z

← Revisión anterior		Revisión del 17:07 17 ene 2026
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	{{~~Peds top~~}} ~~[[chest pain]]~~		{{PediatricPage\|chest pain}}
	==Background==		==Background==
	*Common cause of presentation to the ED, especially in adolescents		*Common cause of presentation to the ED, especially in adolescents

2022-05-14T11:21:21Z

Differential Diagnosis

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 ==Differential Diagnosis==
-*Idiopathic (most common)
+{{DDX CP peds}}
 ==Evaluation==

2021-01-25T04:19:45Z

Differential Diagnosis

← Revisión anterior		Revisión del 04:19 25 ene 2021
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	*Precordial catch syndrome		*Precordial catch syndrome
	**Sudden, intense pain with deep inspiration, self-resolving		**Sudden, intense pain with deep inspiration, self-resolving
			**Usually located to one finger point and the intercostal space (often at apex of heart)<ref>Pickering D. Precordial catch syndrome. Arch Dis Child. 1981;56(5):401-403. doi:10.1136/adc.56.5.401</ref>
	*Musculoskeletal		*Musculoskeletal
	**[[Costochondritis]], [[thoracic trauma\|trauma]]		**[[Costochondritis]], [[thoracic trauma\|trauma]]

2020-08-04T15:58:50Z

Differential Diagnosis

← Revisión anterior		Revisión del 15:58 4 ago 2020
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	**[[MI]]		**[[MI]]
	***Rare, even post-[[Kawasaki]]		***Rare, even post-[[Kawasaki]]
	***Consider [[~~SCAD~~]]		***Consider [[coronary artery dissection]]
	**[[Mitral valve prolapse]]		**[[Mitral valve prolapse]]

2020-08-04T15:58:08Z

Differential Diagnosis

← Revisión anterior		Revisión del 15:58 4 ago 2020
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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
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	**[[MI]]		**[[MI]]
	***Rare, even post-[[Kawasaki]]		***Rare, even post-[[Kawasaki]]
			***Consider [[SCAD]]
	**[[Mitral valve prolapse]]		**[[Mitral valve prolapse]]

2019-11-28T22:52:53Z

← Revisión anterior		Revisión del 22:52 28 nov 2019
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	~~''See~~ [[chest pain]] ~~for adult patients.''~~		{{Peds top}} [[chest pain]]
	==Background==		==Background==
	*Common cause of presentation to the ED, especially in adolescents		*Common cause of presentation to the ED, especially in adolescents

2019-10-19T14:35:06Z

← Revisión anterior		Revisión del 14:35 19 oct 2019
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	*Common cause of presentation to the ED, especially in adolescents		*Common cause of presentation to the ED, especially in adolescents
	*The majority of pediatric chest pain is benign and not cardiac in origin		*The majority of pediatric chest pain is benign and not cardiac in origin
	*The main cause of cardiac chest pain in pediatrics is pericarditis		*The main cause of cardiac chest pain in pediatrics is [[pericarditis]]
	*Family history plays an important part screening for familial history of sudden death		*Family history plays an important part screening for familial history of sudden death

	==Clinical Features==		==Clinical Features==
	*[[Chest pain]]		*[[Chest pain]]
			*Physical exam
			**Listen for murmurs
			**Palpate
			**Compress rib cage

	==Differential Diagnosis==		==Differential Diagnosis==
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	**Sudden, intense pain with deep inspiration, self-resolving		**Sudden, intense pain with deep inspiration, self-resolving
	*Musculoskeletal		*Musculoskeletal
	**[[Costochondritis]], trauma		**[[Costochondritis]], [[thoracic trauma\|trauma]]
	*Pulmonary		*Pulmonary
	**[[Pneumothorax]]		**[[Pneumothorax]]
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	**[[Prinzmetal's angina]] (vasospasm)		**[[Prinzmetal's angina]] (vasospasm)
	**[[MI]]		**[[MI]]
	***Rare, even post-Kawasaki		***Rare, even post-[[Kawasaki]]
	**[[Mitral valve prolapse]]		**[[Mitral valve prolapse]]

	==Evaluation==		==Evaluation==
	*Physical exam
	**Listen for murmurs
	**Palpate
	**Compress rib cage
	*[[ECG]]		*[[ECG]]
	*[[CXR]]		*[[CXR]]

2019-10-05T21:10:48Z

Evaluation