Chest pain (peds): Difference between revisions
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{{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 | ||
*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== | ||
{{DDX CP peds}} | |||
==Evaluation== | ==Evaluation== | ||
*[[ECG]] | *[[ECG]] | ||
*[[CXR]] | *[[CXR]] | ||
*Consider | *Consider [[echocardiography]] | ||
==Management== | ==Management== | ||
| Line 49: | Line 31: | ||
==References== | ==References== | ||
<references/> | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
[[Category:Symptoms]] | [[Category:Symptoms]] | ||
Latest revision as of 11:21, 14 May 2022
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
Chest pain (peds)
- Idiopathic (most common)
- Precordial catch syndrome
- Sudden, intense pain with deep inspiration, self-resolving
- Usually located to one finger point and the intercostal space (often at apex of heart)[1]
- 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
- Rare, even post-Kawasaki
- Consider coronary artery dissection
- Mitral valve prolapse
- Anomalous coronary arteries]
Evaluation
- ECG
- CXR
- Consider echocardiography
Management
Disposition
See Also
External Links
References
- ↑ Pickering D. Precordial catch syndrome. Arch Dis Child. 1981;56(5):401-403. doi:10.1136/adc.56.5.401