What are the Different Pediatric Chest Pain?

The Majority of Chest Pain in Children Falls into the Following Categories:

  • Chest Wall Pain

Patients with this type of chest pain will often complain of sharp or stabbing pain but it is sometimes an aching or a pressure sensation. The pain may occur over the left or right chest or the breastbone. It can be random in nature and occur both at rest and with either light activity or with strenuous exercise. There is often an element of difficulty breathing when the pain in aggravated by taking deep breath or it is difficult to take in a deep breath. It is sometimes mistaken for asthma or reflux but it is neither of these. Chest wall pain is also not from the heart. Some episodes are caused by pain in the bones which would include the breastbone, the ribs, and the cartilage joints that link them together called the costochondral joints.

Other episodes are caused by the muscles in the chest wall, which would include the Pectoral muscles, the muscles coming from the back called the Serratus Anterior, and finally the muscles between the ribs called the intercostals muscles. Episodes of chest pain can also be caused by the diaphragm, which is a large muscle shaped like a dome that is used by the lungs for breathing. Finally, a very common cause of chest wall pain is the lining around the lund called the pleura, which has a lot of nerve fibers.

  • Overextertion symptoms

We all have an upper limit or maximum ability when we exercise very hard. In highly trained athletes, the bones and muscles and cardiovascular system are so highly trained that it is rare to hit that limit. In less trained or inactive individuals doing an unusual activity such as “running the mile” there can be quite a few children who experience overexertion symptoms. When we hit our limit we will be very tired, have trouble breathing, and sometimes have a burning or aching sensation in our chest. This will only occur when we are pushing ourselves very hard.

  • Chest wall injury

Kids can be very busy and in the heat of the moment of play and sports, they may not take note of an injury to the chest. This could mean being hit by a ball or another player or falling hard on the chest. This type of injury will not damage the heart and usually ribs do not break in children because they are mainly cartilage. Sometimes in the next few days after the injury, pain will occur and the person may not remember that they had an injury to the area.

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