GP FAQ chest pain
It is uncommon for children presenting with chest pain to have cardiac abnormalities or other serious underlying pathology.
Common causes of chest pain in children without risk factors for serious disease include:
- Musculoskeletal
- Asthma
- Respiratory tract infections
- Gastro-oesophageal reflux or biliary disease
- Precordial catch – can be experienced in healthy teenagers or young adults
- Anxiety
- Idiopathic
It is important to exclude less common, serious diagnoses. A flowchart and explanatory article can be found from ‘The Royal Children's Hospital Melbourne’ website: https://www.rch.org.au/clinicalguide/guideline_index/Chest_pain/
Local information for clinicians in NW London:
If a child needs an ECG:
- Advise to attend A+E if urgent ECG needed (this is rare)
- Discuss with paediatric consultant via phone, they may advise to:
- refer to general paediatric clinic
- refer to cardiology clinic at St Mary’s Hospital (SMH) or Hammersmith Hospital (HH)
- The Royal Brompton Hospital also has a specialist service for children
- The Waller Unit at St Mary’s Hospital is not able to perform ECGs for patients aged less than 16 years
If a child needs an ECHO:
- Echocardiograms are always carried out in conjunction with a full cardiology assessment
- Refer to paediatric cardiology clinic at Hammersmith Hospital. Please note, on triaging of these referrals, the patient may be booked into a general paediatric clinic instead, if deemed clinically appropriate
- The Royal Brompton Hospital also has a specialist service for children
References:
Chest Pain, Royal Children’s Hospital Melbourne https://www.rch.org.au/clinicalguide/guideline_index/Chest_pain/
Guggel et al. Cuases of non-traumatic chest pain in children. https://www.uptodate.com/contents/causes-of-nontraumatic-chest-pain-in-children-and-adolescents?search=precordial%20catch%20syndrome%20children&source=search_result&selectedTitle=1~2&usage_type=default&display_rank=1
