• 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.