The child complains of pain in the chest in the middle. Chest pain in children If a child has chest pain

Chest pain is a very common reason for children to visit a pediatrician, emergency departments, cardiologists and pulmonologists. The media rightly warns people that chest pain in adults is the first symptom of myocardial infarction and severe heart disease. However, this alertness extends to children, so chest pain is usually perceived by the child and his loved ones as something disturbing and dangerous.

The child and his parents usually want to know if these pains are related to the heart, if they are dangerous and what consequences they may have. When dealing with chest pains, it is convenient to divide them into acute, severe, persistent pains and chronic, recurring, less severe pains. History taking and physical examination, as well as the choice and information content of additional research methods in these situations will differ.

Acute chest pain

These children are usually anxious, seek emergency medical attention, and usually remain in pain during the examination. The history and physical examination are taken quickly to establish immediately whether the pain is related to the heart or not. When collecting an anamnesis, one should pay attention, firstly, to the nature of the pains themselves and related complaints, and secondly, to concomitant diseases that can cause chest pain. It is necessary to find out the time of onset of pain, their duration, nature, strength, localization and irradiation, as well as factors that increase or relieve pain. Pay attention to other complaints such as fever, cough, vomiting, lightheadedness, fainting, palpitations, shortness of breath, sweating. Congenital and acquired heart defects, diseases of the lungs and chest, and diseases of the abdominal organs should be especially noted from concomitant diseases. ECG, echocardiography, and chest x-ray are most important for acute chest pain.

Cardiac causes of chest pain

Diseases of the pericardium

Inflammation and irritation of the pericardium (pericarditis) causes severe pain behind the sternum, which the patient may describe as squeezing or pressing, so it is sometimes difficult to distinguish from angina pectoris. The pain is aggravated by movement, including breathing. The patient tries to find a comfortable position, usually leaning forward and refusing to lie on his back. Pain can be elicited by pressure on the chest. A pericardial friction rub is usually heard. With significant pericardial effusion, friction noise may be absent, while heart sounds are muffled. It is very important not to miss the signs of tamponade.

Angina pectoris and myocardial infarction

This is the most terrible, but at the same time the most rare cause of chest pain in children. The pain is severe, located behind the sternum, patients describe it as burning, pressing or squeezing. It can radiate to the neck and left arm. It usually occurs during exercise and resolves with rest. Physical examination may not reveal any abnormalities. With myocardial infarction, characteristic changes appear on the ECG (ST segment elevation and T wave changes in the leads corresponding to the affected myocardium and reciprocal depression of the ST segment in opposite leads). Find out if there is a history of hypertrophic cardiomyopathy or Kawasaki disease. In addition, especially if there are no indications of heart disease, you should find out if the child uses drugs, especially cocaine (crack). Cocaine causes spasm of the coronary arteries by increasing sympathetic tone, which can lead to myocardial ischemia and infarction. In this case, the pain is not associated with physical activity. Echocardiography can detect abnormalities of the coronary arteries, their aneurysms (in Kawasaki disease), as well as hypertrophic cardiomyopathy.

Arrhythmias

Tachycardias, especially supraventricular ones, may be accompanied by acute chest pain. Usually, children, especially younger ones, complain simply of discomfort in the chest, but at a very high heart rate, coronary blood flow can be disturbed and ischemia occurs. The pain is usually unrelated to exercise and is often accompanied by lightheadedness, fainting, and palpitations. Immediately after the cessation of the arrhythmia, the pain disappears. During an attack, the diagnosis can be made by ECG. Signs of ischemia on the ECG may remain for some time after the cessation of the arrhythmia.

Aortic dissection

The pain usually begins suddenly, cutting or tearing in nature. The irradiation of pain depends on the aortic department: with dissection of the ascending aorta, the pain is localized in the anterior part of the chest, with dissection of the aortic arch, the pain radiates upward (to the neck), and with dissection of the descending aorta - back (usually in the back). Dysmorphogenetic features of Marfan or Ehlers-Danlos syndrome are usually found. The delamination may begin for no apparent reason or after a seemingly minor injury. Aortic dissection should be suspected in all patients with severe chest trauma or hemopericardium. An experienced specialist will quickly make a diagnosis using transesophageal echocardiography. Emergency surgical treatment is indicated.

Non-cardiac causes of chest pain

lung disease

Spontaneous pneumothorax causes severe unilateral chest pain, which is often difficult for the patient to localize. Pain is usually followed by shortness of breath. The diagnosis is indicated by a weakening of breathing on one side, as well as a displacement of the trachea. Pay attention to bronchial asthma, cystic fibrosis, Marfan's syndrome, as well as a history of trauma. Acute chest pain can be caused by pleurisy, which is characterized by pain on inspiration. Pleurisy is most often of viral etiology, in particular with epidemic myalgia, which is characterized by fever and pleural rub. With high fever and intoxication, bacterial pneumonia should be considered. In children with sickle cell anemia, bacterial pneumonia is very dangerous and requires emergency treatment. PE in children is very rare, but should be considered if coughing, shortness of breath, or hemoptysis associated with acute pleuritic pain, especially if there has been a history of leg injury, and in girls taking oral contraceptives.

Diseases of the esophagus and stomach

With gastroesophageal reflux and reflux esophagitis, the pain is usually burning, mild, and located behind the sternum, however, sometimes it can be squeezing and resemble angina pectoris. The relationship of pain with food intake and its increase in the supine position indicate reflux esophagitis. Severe chest pain can occur with a foreign body in the esophagus. Esophagospasm and rupture of the esophageal mucosa with repeated vomiting can cause chest pain, but are rare in children.
When the diaphragm is irritated, the pain usually radiates to the shoulder and lower chest; with fever and normal physical examination of the chest, lungs, and heart, a subdiaphragmatic or hepatic abscess should be suspected. In splenic flexure syndrome, splenic infarction, and splenomegaly in sequestration crisis, pain may be located in the left shoulder. Pancreatitis causes epigastric pain that may radiate to the back. In addition, pancreatitis may be accompanied by pleural effusion, making it difficult to make a correct diagnosis.

Prolonged and recurring chest pain

These patients often come to a scheduled appointment with a doctor, and do not go to the emergency department. During the examination, there is usually no pain in the chest. On physical examination, there are often no abnormalities, the main role in the diagnosis is played by the anamnesis. As with acute chest pain, attention should be paid to the nature of the pain, other complaints, and comorbidities. Since the pain could recur for weeks, months, and even years before going to the doctor, the anamnesis can be quite long. Attention is drawn to events prior to the onset of pain (family troubles, illness or death of loved ones), concerns about pain in the family, the impact of pain on daily activities, including school performance and attendance, as well as previous examinations and diagnoses. The child may understand that the adults around him do not believe in the presence or severity of pain or suspect self-interest behind his complaints.

Collecting an anamnesis and examining the patient, it is necessary to let him know that no one doubts the presence or severity of pain. Parents should be explained that although not always, but usually the cause of the pain can be established. They must understand that cardiac causes, as the most dangerous, will be ruled out first. After that, the differential diagnosis should include less dangerous but more likely causes.

Chronic chest pain

It should be clearly explained that pain can occur in any part of the chest: the chest wall and adjacent structures, the lungs, the esophagus, the part of the stomach adjacent to it and in the heart; however, the latter is the least likely cause of pain. We should not forget about psychogenic pains, but they should be discussed last, after the collection of anamnesis and physical examination.

Diseases of the chest

Pain in the muscles, bones, and joints of the chest wall is the most common cause of chest pain among those cases when it can be found. The pain is usually localized, does not radiate, and can be reproduced. It usually increases with physical exertion due to an increase in the frequency and depth of breathing, which can lead the patient to think about the cardiac origin of pain. The entire chest should be examined for bruising or skin rashes (eg, shingles). In children of both sexes, the mammary glands are examined for the presence of nodules, mastitis, bruising, or necrosis of adipose tissue. Often there is myalgia due to damage and overwork, especially after sports competitions, increased training or a change in sport. It is sometimes possible to reproduce pain on palpation along the ribs and sternum.

There are several syndromes in which the ribs or sternum hurt; they are often confused and confused. Costal chondritis is characterized by pain or tenderness of the anterior chest wall in the region of the costosternal or costocartilaginous joints. There is no swelling. Pain can be mild to severe, is usually unilateral, and is most commonly located at the 4th to 6th costochondral junctions. This syndrome is somewhat more common in girls, may occur after viral infections and intense physical activity. The diagnosis is made if the pain is reproduced on palpation.

Tietze's syndrome is characterized by pain and thickening of the costal-cartilaginous joints, while the skin is not changed; most often the cartilages of the II or III ribs on one side are affected. Pain and swelling are usually intermittent but may persist for months or years, with boys and girls equally affected. Separately, a syndrome is described in which there is a sharp cutting or shooting pain at one point, usually in the region of the apex of the heart, lasting from thirty seconds to several minutes. This pain can occur at rest or during a small physical activity, repeated several times a day. The pain intensifies with a deep breath, so when it occurs, the patients freeze, and then begin to breathe shallowly. The etiology of this pain is not known.

In slipping costal cartilage syndrome, the anterior end of the 8th, 9th, or 10th rib is affected. These ribs do not reach the sternum, and their ends are connected by cartilage. Damage to the latter can lead to the fact that the rib is displaced and superimposed on the one lying on top. In this case, there is a sharp cutting, stabbing or dull pain, which can last for several hours; soreness may remain for several days. Pain can be reproduced if you put your fingers under the edge of the costal arch and pull it forward. With xifoidalgia, pain is localized in the region of the xiphoid process. It can occur both at rest and during exercise. In children, pain at the site of attachment of the abdominal muscles to the xiphoid process may occur after a long run or gymnastics.

If chest wall pain can be reproduced, no further examination is necessary. Treatment begins with assuring the child and his parents that the pain is not related to the heart and is not dangerous. Rest and light painkillers (paracetamol or non-steroidal anti-inflammatory drugs) are usually sufficient. The patient should be warned that the pain may recur. For other diseases (mastitis, shingles, etc.), appropriate treatment is carried out.

lung disease

Bronchial asthma of physical effort as a cause of chest pain in children is becoming more common. With bronchospasm, these children experience deep cutting retrosternal pain and tightness in the chest. It should be remembered that bronchospasm is most pronounced within 5-10 minutes after the cessation of physical activity, and then gradually resolves within 20-30 minutes. Chest pain in this case occurs at the height of physical activity or immediately after its termination. Wiens et al. using a specially designed load test with a rapidly increasing slope of the treadmill, bronchial asthma of physical effort was revealed in 72% of children referred to a cardiology clinic for prolonged chest pain. Therefore, with chest pain associated with physical exertion, one should always remember about bronchial asthma of physical effort.

In bronchial asthma, recurring chest pains can be associated not only with bronchospasm of physical effort, but also with muscle strain with constant coughing. Bronchospasm of physical effort occurs in approximately 40% of children with bronchial asthma.

Chest pain in pneumothorax has been discussed above.

Children, especially those involved in sports, often have acute pain in the right hypochondrium, which sometimes radiates to the right shoulder or xiphoid process. The pain is cutting or cramping, comes on when walking or running, and always goes away when you stop.

Diseases of the gastrointestinal tract

Reflux esophagitis is increasingly common in children, especially in chronic chest pain of unknown etiology. The pain is located behind the sternum, in the region of the heart, or both. Increased pain after eating, with an increase in intra-abdominal pressure or in the supine position is a characteristic, but not an obligatory symptom.

To confirm the diagnosis, esophageal manometry or esophagoscopy can be performed, but with a convincing history, you can immediately begin with trial treatment with H 2 blockers. Rarer causes of chest pain include foreign bodies in the esophagus, achalasia, and diffuse esophagus spasm.

Heart diseases

Actually, cardiac pain in the chest, that is, angina pectoris, occurs when there is a mismatch between myocardial oxygen demand and its delivery. This occurs with obstruction of the coronary arteries due to congenital anomalies or acquired diseases, or with severe hypertrophy of the ventricular myocardium, when the increased myocardial oxygen demand is not satisfied despite normal coronary arteries. With angina pectoris, the pain is short-term, occurs during physical exertion and disappears at rest. Patients usually describe it as pressing or squeezing, much less often as cutting or burning. The association of chest pain with palpitations, lightheadedness, or fainting is always alarming.

Congenital anomalies of the coronary arteries can cause myocardial ischemia in early childhood, and may only appear in adolescents. The most common of these anomalies is the departure of the left coronary artery from the pulmonary trunk. Complaints usually appear already in infancy, but occasionally angina pectoris occurs only in adolescence. Sometimes there is an abnormal origin of the left coronary artery from the right coronary sinus of Valsalva or the right coronary artery from the left coronary sinus of Valsalva. In these children, the orifice of the coronary artery may be slit-like narrowed, or the artery may pass between the aorta and the pulmonary trunk; in the latter case, the expansion of the aorta and pulmonary trunk during exercise leads to compression of the coronary artery. As a result, angina pectoris appears during exercise. In coronary arteriovenous fistulas, ischemia may occur due to the steal phenomenon.

Kawasaki disease is the most common acquired coronary artery disease in children. Aneurysms of the coronary arteries can lead to stenosis or thrombosis of the coronary arteries, resulting in ischemia. It should always be clarified whether the child had Kawasaki disease, however, this disease is not always diagnosed.

Dyslipoproteinemias, including familial hypercholesterolemia, can lead to atherosclerosis of the coronary arteries in childhood. This diagnosis can be indicated by flat xanthomas on the skin, sometimes already at birth. Other metabolic disorders, such as mucopolysaccharidoses and homocystinuria, can also lead to stenosis and thrombosis of the coronary arteries.

With severe ventricular hypertrophy, an increase in myocardial oxygen demand, for example, during exercise, can lead to ischemia of its subendocardial layers and angina pectoris. Severe ventricular hypertrophy may develop with severe aortic or pulmonic stenosis, hypertrophic cardiomyopathy, severe arterial hypertension, or pulmonary hypertension. Severe myocardial hypertrophy increases the risk of angina pectoris and sudden death.

It was thought that atypical chest pains could be due to mitral valve prolapse. However, in a study by Arfken et al. The prevalence of chest pain in children with and without mitral valve prolapse was similar. In addition, the prevalence of mitral valve prolapse among children with chest pain was found to be no higher than in children in general. However, it turned out that in children with mitral valve prolapse as a cause of chest pain, diseases of the esophagus are much more common than in others.

Tachycardias, especially supraventricular ones, can cause angina pectoris. This should always be remembered when examining a child with chest pains, especially if these pains are accompanied by palpitations.

Psychogenic pain

In many children and adolescents, chest pain is psychogenic. There is often a history of trauma prior to the onset of pain, such as death or coronary artery disease in relatives or friends, divorce, broken friendships, school failure, or serious illness. Other family members may have similar complaints. The pain is often very vague, the child can hardly localize and describe it. The location and intensity of pain may vary. Chest pain occurs with hyperventilation syndrome, depression and somatization disorder. There is often pain in the area of ​​the apex of the heart.

Number of sources used in this article: . You will find a list of them at the bottom of the page.

As a teenage girl, you probably feel pain in the chest area. Your breasts hurt because of the changes taking place in your body and the increased release of hormones. You can reduce chest pain in several ways. This involves making some changes in your life (small ones) and taking medications. You should also learn to distinguish chest pain caused by puberty from other causes.

Steps

Lifestyle change

Wear a supportive bra. After going through puberty, your breasts will become heavier. Without a bra, if you have large breasts, you may feel pain as your body has not yet had time to adjust to carrying the extra weight. A supportive bra will take on this weight and help control the pain.

• Go to the lingerie store and pick up the right size, comfortable model.

1. Do exercises to reduce pain. You should develop the inner parts of the chest muscles, the so-called pectoral muscles, which will help you cope with the weight of the growing chest. Perform exercise for the pectoral muscles:

   • Bend your elbows at a right angle and raise them to chest level. Lower to the sides, then raise again to chest level.
   • Perform the exercise 20 times in the morning and evening.

2. Eat fruits and vegetables. Citrus fruits and vegetables contain lycopene and antioxidants. They help prevent free radicals in the body that cause chest pain. Citrus fruits also strengthen the immune system and improve overall health.

   • Good choices are: oranges, melons, tomatoes, spinach and papaya.

3. Reduce your caffeine intake. Caffeine contains methylxanthines, which cause pain. They stimulate the production of cyclooxygenase enzymes, a pain-accelerating mechanism in the body that thus enhances pain sensations. Excessive caffeine intake can also disrupt your sleep, further exacerbating pain. Foods containing caffeine include:

   • Coffee and black tea
   • Most carbonated drinks
   • Energetic drinks
   • Chocolate

4. Limit your salt intake. Salt leads to fluid retention in the body and bloating, which as a result contributes to breast swelling. All this can lead to an increase in sensitivity. Reduce your salt intake and make sure you get enough water.

   Use oils with vitamin E content. Vitamin E is fat soluble, which allows it to function as an antioxidant. Antioxidants protect your body tissues, including breast tissue, from damage caused by free radicals. Vitamin E will also help relieve inflammation that leads to tenderness and pain in the breasts.

   Seek medical attention if there is purulent or bloody discharge. Seek immediate medical attention if you notice blood or pus coming out of your nipple and feel pain. All these are signs of inflammation, which is treated with antibiotics.

   Recognize other signs of infection. Detection of local foci of increased sensitivity and pain (meaning concentration at one point) may indicate the presence of an infection. Such local sensitivity does not have to be accompanied by blood or pus. Instead, you may notice part of your breasts are swollen or red.

   If an infection is found, you will need to take antibiotics. Antibiotics are designed to fight infection, including in the area of ​​​​the mammary glands. If you have a breast infection, you may be prescribed various types of antibiotics; consult with your doctor about the choice of the most suitable ones for you.

Adults often associate chest pain in a child with heart ailments. But in reality this is far from the case. Studies conducted in the United States have shown that in adolescents and young children, chest pain is not associated with heart disease in 99% of cases.

This study involved more than 3,700 children from Boston with heart pain, patients of the Boston Hospital, and only 1% of them were found by doctors cardiovascular diseases. What are the real causes of chest pain in children and what to do about it?

Causes of chest pain in children

The study, which we wrote about above, involved children whose average age reached 14 years. 99% of them had bone disease, as well as diseases:

musculoskeletal system;

digestive system;

central nervous system (CNS).

Some children have had chest pains due to uncontrolled use of medications that caused allergy. And only 1% of children experienced chest pain due to cardiovascular problems. Therefore, doctors strongly advise parents who have found chest pains in their children, first of all, to do an ECG.

This will immediately eliminate the risk cardiovascular disease or confirm heart problems. And then you need to navigate the picture of the disease. This will make it possible not to waste time on the use of drugs for cardiovascular ailments. This time will be useful to identify the real cause. chest pain in children. So, the true causes of chest pain in children can be:

Psychogenic pain;

skin damage or disease;

pain in violation of the muscles;

respiratory system disorders;

cardiovascular diseases;

lesions of the gastrointestinal tract.

First, you need to ask the child in detail where exactly he has pain, because young children very often indicate different places. Therefore, pain in the pit of the stomach, indicating diseases of the digestive system, easy to confuse with chest pains - the child can call both parts of the body breasts. Also ask your child about the nature of the pain that worries him. Let's look at each of the causes of chest pain in a child in more detail.

Pain in skin diseases

Pain in diseases or skin lesions can disturb the child if he has herpes, or shingles. This disease tends to affect the skin rash, sores or vesicles. And then the child complains of burning pains in the chest. They may be accompanied by fever or lymph nodes that are significantly enlarged.

Shingles, or herpes is viral disease, which, moreover, is infectious, that is, it is transmitted from child to child. To cure him, you need to call the local doctor and follow the treatment regimen that he will prescribe.

Diseases of the musculoskeletal system

Pain in the chest of a child due to diseases of the musculoskeletal system can be quite strong and acute. Sources of pain can be changes in the vertebral processes after injury, pain due to cartilage lesions in the spine, rheumatoid arthritis, tuberculosis. All these diseases lead to infringement of the nerve roots, and this is very painful. It is necessary to take the child to a rheumatologist for diagnosis and treatment.

Respiratory system diseases

Chest pain in a child, most often can occur due to injuries or inflammation of the lungs. This respiratory organ is surrounded by the pleura, the membrane that lines the chest cavity. When the pleura is inflamed, its sheets (it consists of sheets, very thin) rub against each other, and this causes severe chest pain in the child. They are very difficult to endure, the pain is even more intensified during deep breathing and can be given to the shoulder joint.

A child may experience similar pains when the inflammation of the lungs has worsened, the lungs are in serious condition, they are inflamed and affected by the virus. In this condition, self-medication is unacceptable. It is necessary to immediately call a doctor and treat the child in a hospital, as a rule, antibiotics.

Cardiovascular diseases

Cardiovascular pain in the chest of a child is one of the most dangerous types of pain. They can occur with various diseases of the heart and blood vessels, in particular, rheumatism, SARS (acute respiratory infections), which cause inflammation of the lining of the heart - the pericardium or inflamed muscles of the heart (the disease is called myocarditis).

Cardiovascular diseases not associated with myocardial infarction or angina pectoris, can be recognized by dull and pulling pains, such pains can radiate (spread) to the neck or shoulder. If the heart and blood vessels are not normal, this is a great danger to the child. You need to consult a doctor immediately. He will prescribe treatment depending on the nature of the disease.

Diseases of the digestive system

Chest pain a child with diseases of the gastrointestinal tract can be very strong and indicate serious health problems. It can be congestion in the digestive tract, gas reflux disease(heartburn), inflammation of the esophagus, and poisoning with substances that can irritate the delicate lining of the esophagus or stomach.

Diseases digestive system, that cause pain in the child's chest, there may be a stomach or duodenal ulcer, a hernia of the esophagus, a foreign body that the child swallowed (for example, a bone). Such pains can be recognized by their nature: they become worse when swallowing, lying down or when the child leans forward. Accompanying symptoms - difficulty swallowing, vomiting with blood, stools with black discharge, and increased salivation.

You need to immediately call an ambulance and take the child to the hospital. First of all, he needs to endoscopy of the esophagus(examination of the esophagus using computer diagnostics and a device called an endoscope). Then the doctor will prescribe treatment depending on what diseases the child suffers from.

Psychogenic chest pain

Psychogenic pain in the chest can begin if the child is not sick with anything, but is experiencing a state of acute stress. Then muscle clamps appear in the chest, and the child complains of chest pains. The child can also worry about the condition of a person close to him, for example, his mother, and imitate chest pains that she suffers from. Psychogenic pain can be determined by the time they occur. As a rule, these pains disturb the child only in the state of wakefulness, and in the state of sleep or during the child's passion for a game or an interesting book, the pain disappears.

It is necessary to give the child the opportunity to relax more, play, be in the fresh air. If chest pains do not go away, you need to show the child neuropathologist and a psychologist.

Sudden severe stabbing pain of unknown etiology can occur in a child, most often after eating or with a strong physical stress. This pain may be accompanied by contractions in the chest area (attacks of pain), localized in the upper abdomen or lower chest. As a rule, such pain is more often localized on the right. The causes of such pain may be tense ligaments between the abdominal membrane (peritoneum) and the diaphragm.

Pain of this nature in a child should pass after he rests and calms down. The child should lie down, the ligaments of the peritoneum will relax and then all the pain will pass.

Chest pain due to muscle problems can occur after injuries, muscle strains, bruises, and also due to viral infections in the muscles. The latter disease leads to inflammation of the muscles, which is called viral myalgia. It is characterized by the fact that the muscles of the child in the chest area become very painful, and this pain comes unexpectedly, it is strong, it is felt even when lightly pressed with fingers. The site of pain, as a rule, is only this one, there are no other deviations in the child's condition.

For bruises and sprains, alternate heat and ice (15 minutes each). Warm compresses can be salt heated in a pan or a warm heating pad. You can also heat a woolen handkerchief on a warm radiator and attach it to the child's sore chest.

If your chest hurts a lot, you can give something from an anti-inflammatory and pain reliever, such as ibuprofen. You can also give your child panadol - it relieves pain and inflammation well.

The nature of chest pain in a child

If the pain increases with movement, it is most likely caused by an injury or muscle tension. It can also be muscle strain or inflammation. Parents should pay attention to these symptoms even if there are no bruises or other signs of injury on the child's chest. An additional symptom is pain with light touch, breathing, coughing.

If the pain in the child's chest is concentrated in only one place that hurts constantly, this may be the result rib fracture. Additional symptoms - a sharp pain when moving, touching, and this pain is in the area where the ribs are located. This pain doesn't go anywhere else.

Strong and sharp pain in the chest of the child, as it were, behind the sternum, behind is a symptom of a sore throat or a cold. Such pain can be caused by a disease of the trachea, in particular, its inflammation. Microorganisms that cause angina and tracheitis- same. An additional symptom in this disease is dry cough Pain that worsens with deep breathing.

Pain in the chest of a child in the form of a burning sensation that occurs after eating is a sign of the disease digestive system, in particular the stomach. This pain is caused by acid rising from the stomach back into the esophagus. There are children who especially often suffer from heartburn and high acidity. To avoid this condition, you do not need to overeat and bend over after eating, but sit straight. If these simple remedies do not work, you need to take the child to the doctor.

Pain in the chest of a child during a cough is a sign of a disease of the respiratory system, in particular, pneumonia. If a child coughs often and for a long time, so he can stretch intercostal muscles they get inflamed and hurt. The pain is aggravated by palpation of the chest. These pains will quickly pass as soon as the cough itself passes.

Whatever the pain in the chest of a child, this symptom should not be overlooked, because it can be a signal of serious illness. In order not to be convinced of the presence of these diseases in practice, you need to pay attention to them at an early stage in order to diagnose and treat them in time.

Pain and its causes in alphabetical order:

chest pain in children

Chest pain in children is an uncommon occurrence in the general pediatric population, but a fairly common reason for visiting a pediatric cardiologist and for emergency care, due to the fact that chest pain is often associated with atherosclerotic heart disease and heart attack in adults.

Pain when breathing in young children is recognized by external manifestations. Older children report it themselves, albeit to a limited extent. Sensory innervation of the chest is provided by the intercostal nerves segmentally. Almost half of all sensory fibers approach the diaphragm as part of the phrenic nerve. Pain sensitivity of all organs in the chest cavity is provided only by sympathetic nerves. Therefore, pain in the chest wall is perceived as superficial, accurately described, localized and delimited. Visceral pain due to damage to the organs of the chest cavity, on the contrary, often radiates, is dull, diffuse and is perceived as coming from the depths.

Pain in the chest wall can be classified as follows: constant pain; pain not dependent on breathing; pain that occurs only when breathing; constant pain, aggravated by breathing. Pain during movements not related to breathing is caused by damage to the vertebrae, ribs and muscles. If such pain also occurs during breathing, during coughing, sneezing or laughter, then in addition to this pathology, one should think about damage to the pleura. Children describe their pain sensations incompletely and inaccurately, therefore objective research methods and their consistent implementation are crucial for them: thorough examination, palpation, percussion, auscultation, X-ray examination, complete blood count, tuberculin diagnosis.

What diseases cause chest pain in children:

Chest pain in children may indicate the presence of dangerous diseases.

Most children have ever complained of chest pains. It is necessary to find out the exact location of the localization of pain, since the child often calls the epigastric region of the abdomen the breast. The following details are important: how movements affect the nature of pain, whether they occur during muscle tension after eating, whether they appear during physical work or during sleep, whether the child suffers from bronchial asthma.

1. Sudden sharp stabbing pain in the chest: This condition is characterized by cramping pain in the lower part of the chest, usually on one side, or in the upper abdomen. As a rule, occurs after eating during physical exertion. This pain is caused by tension in the peritoneal ligaments (the sheath that covers the abdominal cavity) that are connected to the diaphragm.
Help: calm the child, let him rest. After a while, the pain should subside spontaneously.

2. Psychogenic chest pains: if any of the adult members of the family constantly complains of chest pains, then the child may begin to imitate them. This kind of pain does not occur when the child is sleeping or playing. Stress and anxiety can cause pain anywhere, including in the chest. In this case, the diseased area has blurred boundaries, and the child cannot accurately determine the area of ​​pain.
Help: Try to distract the child by talking or playing.

3. Pain in skin diseases: chest pain can occur with herpes zoster. In this case, a rash can be seen on the skin in the form of grouped red bumps or vesicles. In addition, there is an increase in body temperature and an increase in lymph nodes.
Help: since shingles is an infectious disease, it is better to call a doctor at home and not take the child to the clinic, where he can infect other children.

4. Pain of muscle origin: a common cause of complaints of chest pain in children is contusions or viral myalgia (inflammation of the muscles caused by a viral infection). Pain usually occurs unexpectedly, has a clear localization. Muscles in the affected area are painful to the touch. There are no other painful symptoms.
Help: the imposition of heat (heating pad, woolen cloth) on the sore spot helps. For severe pain, you can give a crushed aspirin or panadol tablet. Doses are prescribed by the doctor after examination.

5. Pain in the defeat of the spine: disease of the cartilaginous tissue of the ribs (costochondritis), damage to the processes of the vertebrae in trauma, tuberculosis or rheumatoid arthritis leads to pinching of the nerve and pain in the chest.
Help: to eliminate the cause of pain, it is necessary to treat the underlying disease.

6. Pain in lung diseases: It is reasonable to think about this cause of pain, especially when other symptoms of pneumonia are present - cough and fever. If your child has pain similar to pleural pain, see a doctor immediately.
Help: inflammation of the pleura of an infectious nature is more common in severe pneumonia. The child needs urgent hospitalization.

7. Pain in cardiovascular diseases: with rheumatism, tuberculosis, after acute respiratory infections, pericarditis (inflammation of the membrane covering the heart) or myocarditis (inflammation of the muscle tissue of the heart) may develop. In this case, the pain is usually dull, aching without a clear localization, and can radiate to the shoulder or neck. It is aggravated by swallowing and with vigorous respiratory movements. At the same time, murmurs are heard in the heart, synchronous with heart beats.
Help: the child should definitely consult a doctor. When the diagnosis is confirmed, hospitalization is necessary.

8. Pain in the esophagus: pain in the sternum can be caused by inflammation of the esophagus (esophagitis) if the child has swallowed a substance that irritates the mucous membrane. Other causes of pain are a foreign body in the esophagus (for example, a fish bone), a hiatal hernia, and an esophageal ulcer. The pain is aggravated by swallowing, lying down or leaning forward. In addition, the child may have difficulty swallowing, vomiting blood, black stools, or excessive salivation.
Help: the child needs an endoscopic examination of the esophagus, which can only be done in a clinic or hospital. If the symptoms are threatening, for example, sharp pain when swallowing, bloody vomiting, you need to call an ambulance.

9. Sometimes physical exercise can cause a harmless, albeit intense pain in the child's chest, which occurs in the lower part of it, usually in front of the side. It passes after a few minutes of rest from physical activity.
The cause of this pain is unclear; perhaps the pain is due to the tension of the ligaments that attach the diaphragm - a group of muscles that separate the chest from the abdominal cavity - to the ribs.

10. Chest pain that worsens with movement is likely to be traumatic, even if there are no external signs of trauma. Usually the bruised place acquires painful sensitivity. As in the case of pleural pain, this pain increases slightly with a deep breath or cough, but it reacts much more strongly to the movements of the body, limbs. Unlike pleural pain, it is characterized by increased pain when pressing on the site of pain.
Pain that is localized in one place of the chest, which acquires painful sensitivity, most likely indicates a fracture of the rib, especially if it appears after a serious injury. The suspicion of a rib fracture is confirmed if pressing the sternum from the front causes pain in the previously arisen area of ​​pain in the projection of the rib.
Broken ribs heal on their own in a few weeks without any treatment. However, despite this, if you think that your child has a broken rib, then consult a doctor to confirm the diagnosis and make sure that the lungs are not damaged.

11. Acute pain behind the sternum with a cold or sore throat may indicate tracheitis - inflammation of the trachea. Tracheitis is caused by the same microbes as tonsillitis. A common symptom of the disease, in addition to pain, is a dry cough. Tracheitis resolves in a few days. Paracetamol can be used to relieve pain.

12. The development of the mammary glands in girls and boys during adolescence can cause swelling of the glands and, as a result, pain in the chest. However, they are short-lived and usually last no more than two months.

13. Inflammation of the breast tissue. This disease in adolescents is known as costochondritis (inflammation or infection at the junction of the ribs with the sternum).

Be sure to consult your doctor if:
- Pain in the chest is accompanied by other symptoms: frequent cough, slight fever.
- Pain caused by a slight blow or trauma to the chest persists, but not in an intense form, for more than one day. In such a situation, the pain, although constant, should not interfere with the child's normal activities.
- There are frequent moderate chest pains.

You should tell your doctor immediately if:
- Chest pain is severe and constant. The pain is accompanied by a high temperature, above 38.5 ° C.
- The child cannot take a deep breath because of the pain.
- The child cannot lead a normal life, the child breathes often, he does not have enough air, the temperature is elevated.
- The child has been hit in the chest or injured, but can walk and move despite severe pain.

Which doctors to contact if there is chest pain in children:

Do you experience chest pain in children? Do you want to know more detailed information or do you need an inspection? You can book an appointment with a doctor Eurolaboratory always at your service! The best doctors will examine you, study the external signs and help identify the disease by symptoms, advise you and provide the necessary assistance. you also can call a doctor at home. Clinic Eurolaboratory open for you around the clock.

How to contact the clinic:
Phone of our clinic in Kyiv: (+38 044) 206-20-00 (multichannel). The secretary of the clinic will select a convenient day and hour for you to visit the doctor. Our coordinates and directions are indicated. Look in more detail about all the services of the clinic on her.

(+38 044) 206-20-00

If you have previously performed any research, be sure to take their results to a consultation with a doctor. If the studies have not been completed, we will do everything necessary in our clinic or with our colleagues in other clinics.

Do you have chest pain in children? You need to be very careful about your overall health. People don't pay enough attention disease symptoms and do not realize that these diseases can be life-threatening. There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that, unfortunately, it is too late to treat them. Each disease has its own specific signs, characteristic external manifestations - the so-called disease symptoms. Identifying symptoms is the first step in diagnosing diseases in general. To do this, you just need to several times a year be examined by a doctor not only to prevent a terrible disease, but also to maintain a healthy spirit in the body and the body as a whole.

If you want to ask a doctor a question, use the online consultation section, perhaps you will find answers to your questions there and read self care tips. If you are interested in reviews about clinics and doctors, try to find the information you need on. Also register on the medical portal Eurolaboratory to be constantly up to date with the latest news and information updates on the site, which will be automatically sent to you by mail.

The symptom map is for educational purposes only. Do not self-medicate; For all questions regarding the definition of the disease and how to treat it, contact your doctor. EUROLAB is not responsible for the consequences caused by the use of the information posted on the portal.

If you are interested in any other symptoms of diseases and types of pain, or you have any other questions and suggestions - write to us, we will definitely try to help you.

Chest pain can be caused by various causes, sometimes extremely life-threatening. That is why it should never be ignored, no matter how old you are. Even a child, especially if he is physically active, may complain of pain in his chest after playing or training.

Most often, chest pain in most adolescents and children is not related to the heart. In other words, these are non-cardiac causes. Some of these go away on their own, but other symptoms may indicate the development of a serious heart condition. Therefore, regardless of the type of chest pain, it is important for the child's parents to see a doctor right away!

1. Musculoskeletal Causes

Musculoskeletal problems are the most common cause of chest pain in children and adolescents. Such chest pain can occur due to various abnormalities in the musculoskeletal system.

bone pain syndrome

• Characterized by sharp, stabbing pain;
• soreness is aggravated by deep breathing and hand movements;
• usually lasts from a couple of seconds to several minutes.

Tietze syndrome

• Usually occurs in adolescents and young adults;
• pain may be caused by an upper respiratory tract infection with excessive coughing;
• signs of inflammation in the form of hot spots, swelling and soreness are noticeable on the chest;
• the affected cartilages are well palpated.

idiopathic pain

• Non-specific soreness of the chest, which is often found in children;
• It is manifested by acute pain in the chest, which can last for several minutes.
• symptoms are aggravated during rapid breathing.

slip syndrome

• This type of pain can radiate to the lumbar region;
• felt in the lower chest or upper abdomen, which may be caused by an injury or dislocation of the 8th, 9th, or 10th rib
• in some cases, surgery is required to stabilize the sliding rib.

Muscle injury or strain

• Gymnastics and sports are often accompanied by chest injuries;
• characterized by localized pain and swelling in the affected area;
• weightlifting can lead to serious chest injury if the exercises are done incorrectly.

Precordial Syndrome

• May be caused by poor posture or even a pinched nerve;
• characterized by sudden, sharp pain that can last from a couple of seconds to several minutes;
• felt even at rest or with moderate activity.

Xyphodynia

• This condition is also known as xiphoid hypersensitivity;
• characterized by localized pain or discomfort;
• soreness worse after eating heavy food, coughing, double bending and twisting.

2. Pulmonary causes

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Many children and teens may experience chest pain due to problems in the respiratory system. The most common cause of lung pain is bronchial asthma. Sometimes exercise can cause asthmatic symptoms, even in children with normal breathing.

Infections in the lungs, including bronchitis, pleurisy, pneumonia, empyema, bronchiectasis, and lung abscess, can also cause acute chest pain. It can also be exacerbated in cold climates. One important symptom of this type of chest pain is coughing.

3. Gastrointestinal causes

Discomfort in the stomach can cause chest pain. Common gastrointestinal causes of chest pain in children and adolescents include gastroesophageal reflux disease (GERD), peptic ulcer disease, spasm or inflammation of the esophagus, and cholecystitis. In addition, such sensations can be caused by a foreign object in the esophagus. The most common symptom is a burning sensation.

4. Psychological reasons

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Chest pain in children and adolescents can also be caused by certain psychological problems. These include anxiety and stress experienced at school or at home. Stressful events often present not only with chest pain but also with shortness of breath. There are also sleep disturbances.

Hyperventilation caused by anxiety or a panic attack can cause pain in children. In addition to these symptoms, they may experience dizziness and difficulty breathing.

These are just some of the common causes of chest pain in children and teens that are not related to heart disease. Do not forget that many of these symptoms can be a sign of a serious illness. To find out the exact cause of chest pain, be sure to take your child to the doctor!

Important: All information provided on the Fabios website is for INFORMATION only and does not replace advice, diagnosis or professional medical care. If you have any health problems, contact a specialist immediately.