- Inflammatory: pericarditis, myocarditis
- Arrhythmias (like SVT)
- Cardiomyopathy (any type)
- Aortic stenosis or other obstruction to LV outflow
- Mitral valve prolapse
- Congenital or acquired coronary artery abnormalities.
- Aortic dissection or rupture (secondary to aortic aneurysm)
- Pulmonary hypertension
- Drugs: cocaïne / sympathomimetic overdose
When to seek medical attention:
- Chest pain triggered and worsened by exercise
- Chest pain associated with sustained, rapid unpleasant beating of the heart
- Chest pain associated with syncope
- Abnormal findings on examination of the heart
- Family history of serious inherited heart disease
- Family history of unexpected deaths in young people (age <35 yrs.)
Urgent attention required if the chest pain is persistent and associated with:
- Fever, sweating, shortness of breath, fast heartbeat, or pallor
- Family history of aortic dissection (tearing of the aorta)
- Family history of Marfan syndrome Past history of Kawasaki disease
Our Paediatric Cardiology consultant will undertake a detailed history and Clinical examination to exclude a cardiac cause. As part of the clinical assessment, the consultant will organise various investigations such as blood tests, chest x-ray, ECG, Echocardiogram, heart monitor, standing test, and exercise test.
Any identified cardiac cause needs to be treated with medications and monitored closely. Often normal cardiac investigations and a reassurance that the heart is normal suffice to give relief to the chest pain and related anxiety.
