‘Mommy, am I having a heart attack?’
It’s a frightening moment for a parent when a child complains of chest pain. Could it be a heart condition?
“This is a very common complaint,” said Cape Cod Hospital pediatrician Janelle Laudone, MD. “When it happens, parents set up appointments to see their pediatrician or they bring the child to the emergency department. We see it in kids of all age groups, from younger kids from age 5 up though adolescents.”
The good news is that what the child and parents worry might be a heart issue usually turns out to be something else – something minor.
“Parents worry that it’s the heart because it’s the major organ they think about in the chest,” said Dr. Laudone. “They may have known older adults who had chest pains and it turned out to be something serious, so it’s at the front of their minds that chest pain equals heart problems. But that is generally not the case with children.”
Chest pain in a child can have a variety of causes, said Dr. Laudone.
“Often it’s a sports injury, either a direct injury to the chest wall or a muscle strain from moving, exercising or twisting. Another cause is if they’re ill and have a cough. Frequent coughing can strain the chest wall muscles.”
Between homework and peer relations, children can face daily stress that may result in chest pain, she said.
“That sort of stress can create pain in lots of different places,” she said. “Kids will complain of head pains and chest pains or stomach pains, and that all can be traced back to stress.”
If your child is having chronic pain in any area and is stressed, it’s worth going to the doctor to get checked out to be sure there’s nothing more serious going on, she said.
“Then hopefully your doctor can point you in the direction of resources or talk about ways to manage the stress, so hopefully the pain is lessened.”
Watch For Red Flags
Dr. Laudone recommends a short video produced by the Cincinnati Children’s Heart Institute. In the video, pediatric cardiologist Nicolas Madsen says that it’s less than 1 percent of the time that a child’s chest pain is related to heart issues.
The red flag symptoms that require evaluation sooner rather than later are chest pain that only happens with exertion (during gym class or playing sports, for example) and not at other times, and chest pain that is associated with feeling dizzy and passing out, said Dr. Laudone.
“Those would be the concerning things that would need a medical evaluation,” she said. “But any time a child is worried about chest pain, it’s perfectly reasonable to go to their doctor and have it investigated.”
The doctor will take a history, ask questions and do a physical exam. That will narrow down the cause of chest pain and usually it’s not a heart issue, she said.
When in doubt, it’s always good to see your doctor, even if you think it’s not related to the heart, she said.
“Children see adults on TV with chest pain and they can get worried that it’s their heart that is causing problems, when more often than not it’s the muscles in the chest wall or some other cause that’s causing the pain. Getting some reassurance can put your mind and your child’s mind at ease.”