Chest Pain

Chest pain is a frequent complaint in children, with the highest incidence in the early teenage years. Musculoskeletal structures of the chest wall are the common culprits; cardiac reasons are rarely the cause but should always be considered.

Causes of chest pain in children

Evaluation of chest pain in children

A good history, including a family history, may help exclude serious causes of chest pain. Benign chest pain is not associated with other symptoms. Chest pain with exercise should raise the suspicion of potentially serious causes and warrants further investigations especially if associated with lightheadedness or presyncope. Exercise induced asthma should also be suspected.

An EKG should be done for any patient with chest pain. Further investigations including echocardiography or other imaging modalities depend on the history and physical examination. An exercise stress test may be done if the chest pain is associated with physical activities.


The management is directed to the underlying cause. Musculoskeletal chest pain and costochondritis are managed by reassurance and non-steroidal anti-inflammatory medications. Exercise induced asthma is managed with bronchodilators. Cardiac causes of chest pain are managed according to the specific etiology.