Diagnostic evaluation of children admitted to pediatric cardiology outpatient department due to chest pain

Abstract

INTRODUCTION: Chest pain is a common complaint in children.However, cardiac chest pain is rarely seen.The aim of our study was to determine the diagnostic reasons in children who applied to the pediatric cardiology clinic for chestpain. METHODS: 210 cases were enrolled in the pediatric cardiology outpatient clinic between March 2017 and October 2017 with a chest pain complaint.The patients were aged between 3-18 and 111 of them were female and 99 of them were male.Family history,pathologic findings in the examinations,drug use history,electrocardiography and echocardiography results were recorded from the patients' files. The data is evaluated statistically,the etiologic causes and the frequency of the diagnoses and the distributions according to sex and age were examined from the files of the patients.SPSS 22.0 program was used in the analysis. RESULTS: It was found that chestpain occurred most frequently at rest(66.1%) and at the left side sternum(70.7%).Musculoskeletal(43.8%),idiopathic(28.1%) and psychogenic(14.7%) causes were the most common reasons of chest pain.In one patient cardiac(0.5%) chestpain was detected.Psychogenic chest pain was seen more frequently in girls(54.8%).It is found that most frequent psychogenic causes were depression(68%),anxiety disorder(25.6%) and panic attack. DISCUSSION AND CONCLUSION: Only a small proportion of childhood chest pain is cardiac-dependent.Idiopathic,musculoskeletal and psychogenic causes should be kept in mind as the cause of chest pain.The finalization of the diagnosis is crucial to relieve the anxiety of the patient and his family and to give correct treatment.Referral to the cardiology unit may not always be an appropriate option as it increases the concerns of the family and may result in expensive long-term evaluations.

Keywords

• child
• chest pain
• non-cardiac
• psychosomatic