Pediatric Chest Pain

1. Gal Barbut, MD* 2. Joshua P. Needleman, MD* 1. *Maimonides Children’s Hospital, Brooklyn, NY * Abbreviations: ECG: : electrocardiogram NSAID: : nonsteroidal anti-inflammatory drug SCAMP: : standardized clinical assessment and management plan Lack of familiarity with a systems-based approach and differential diagnosis of chest pain in pediatric patients may lead to inappropriate use of electrocardiography and echocardiography. Clinicians should be aware of the various causes of chest pain in children and the current guidelines and algorithms being used to determine which children are at risk for cardiac chest pain and should have further testing performed. After completing this article, readers should be able to: Chest pain is a common complaint in the pediatric population, encountered in both outpatient settings and emergency and urgent care settings. There are numerous causes of chest pain in children, with most studies ultimately not determining an etiology (1) or attributing the pain to musculoskeletal causes. The complaint may be anxiety provoking for patients, their families, and care providers alike because a cardiac cause is often feared (2)(3)(4); however, the incidence of a cardiac-related cause for chest pain in the pediatric population is exceedingly low, ranging from 0.2% to 1% of cases. (5)(6)(7) Most etiologies of chest pain in pediatric patients can be grouped into musculoskeletal, pulmonary, gastroenterologic, psychogenic, or cardiac causes. Despite …