Chest Pain

What causes chest pain in children?

Chest pain is a common symptom in adolescents and accounts for about 10% of A&E visits. Most children with chest pain do not have any serious heart disease.
Common cause of the chest pain is Musculo-skeletal (costochondritis and precordial catch).

Less commonly pain can be secondary to persistent coughing (asthma, bronchitis) or referred from the abdomen (constipation, coeliac disease), or spine (unrecognised injury).

Rarely (<1%) are attributable to a heart disease like pericarditis, myocarditis, or cardiomyopathy. A fast heart rate (arrhythmia) can present as chest pain in children.

Cardiac causes of chest pain (<1%)

  • 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.

Book an Appointment

Concerned your child may have a food allergy? Worried about your child’s blocked nose?
Not sure if your child has a hearing problem?
Relax! Our expert paediatric consultants and nurses are there to help you.
Book an appointment
Our Medical Consultants and Surgeons are registered with the GMC (General Medical Council) and are regulated by the Care Quality Commission (CQC). The CQC is an independent regulator for health and social care in England. 
© All rights reserved