Chest pain (peds)

DDx

1. Idiopathic (most common)
2. Precordial catch syndrome
   1. Sudden, intense pain w/ deep inspiration, self-resolving
3. Musculoskeletal
   1. Costochondritis, trauma
4. Pulmonary
   1. Ptx
5. GI
   1. Esophagitis)
6. Psychosomatic
7. Cardiac (1%)
   1. Left-sided obstructive lesions
   2. Dysrhythmias
   3. HOCM
   4. Pericarditis
   5. Prinzmetal's angina (vasospasm)
   6. MI
      1. Rare, even post-Kawasaki
   7. Mitral valve prolapse

Work-Up

1. Physical exam
   1. Listen for murmurs
   2. Palpate
   3. Compress rib cage
2. EKG
3. CXR
4. Consider echo

Source

Adapted from Pani