Abstract
Chest pain (CP) in children/adolescents is a common referral for the pediatric cardiologist. A group of 263 patients (141 males/122 females, mean age = 13.4 years, range = 5–22 years) with the primary complaint of CP underwent evaluation in the cardiac stress lab at Children’s Hospital of Wisconsin. Echocardiograms at rest were obtained in 70% of patients with no significant cardiac abnormalities identified. Endurance time (EXT) and oxygen consumption (VO2/kg) were below predicted in 26% and 46%, respectively. Reactive airway disease (RAD) as a preexisting condition was reported in 19% of patients, but abnormal resting pulmonary function (PFTs) were found in 26% (n = 68), with 48/68 never having the diagnosis of RAD. At risk of overweight (BMI >85th percentile), was seen in 28% of the cohort, with 16% identified as being overweight (BMI >95th percentile). A significant difference in RAD (p < 0.01) was seen in African Americans (AA) and decreased EXT (p = 0.01) was seen in Hispanics (H). VO2/kg was significantly reduced in both AA and H (p < 0.01). These results identify both racial and age-related differences in the etiology of CP in children. Most importantly, true cardiac pathology is extremely rare. AOW, deconditioning, and respiratory compromise play important roles in CP. The need for comprehensive cardiopulmonary monitoring is emphasized by these findings.
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References
Brenner J, Ringel RE, Berman MA (1984) Cardiology perspectives of chest pain in childhood: a referral problem? To whom? Pediatr Clin North Am 31(6):1241–1258
Bruce RA (1971) Exercise testing of patients with coronary heart disease. Principles and normal standards for evaluation. Ann Clin Res 3:323–332
Cummings GR, Hastman L (1978) Bruce treadmill protocol in children: normal values in a clinic population. Am J Cardiol 41:70–75
Evans R (1992) Asthma among minority children: a growing problem. Chest 101(6):368S–371S
Geggel RL (2004) Conditions leading to pediatric cardiology consultation in a tertiary academic hospital. Pediatrics 114:409–417
Godfrey S (1974) Exercise testing in children. Sanders, London
Kocis KC (1999) Chest pain in pediatrics. Pediatr Clin North Am 46(2):189–203
Nudel DB, Diamant S, Brady T, Jarenwattananon M, Buckley BJ, Gootman N (1987) Chest pain, dyspnea, on exertion, and exercise induced asthma in children and adolescents. Clin Pediatr 26(8):388–392
Polgar G, Promadhat V (1971) Standards in pulmonary function tests In: Polgar G (ed) Pulmonary function testing in children; techniques and standard. W.B. Saunders, Philadelphia, pp 254–260
Selbst SM (1990) Chest pain in children. Am Fam Physician 41(1):179–186
Selbst SM, Ruddy RM, Clark BJ, Henretig FM, Santulli T (1988) Pediatric chest pain: a prospective study. Pediatrics 82(3):319–323
Tunaoglu FS, Olgunturk R, Akcabay S, Oguz D, Gucuyener K, Demirsoy S (1995) Chest pain in children referred to a cardiology clinic. Pediatr Cardiol 16(2):69–72
United States Centers for Disease Control and Prevention (1998) Forecasted state-specific estimates of self-reported asthma prevalence. Morbid Mortal 47(47):1022–1025
United States Centers for Disease Control (1998) Surveillance for asthma—United States, 1960–1995. Morbid Mortal 47:SS-1
Wiens L, Sabbetha R, Ewing L, Gowdamarajan R, Portnoy J, Scagliotti D (1992) Chest pain in otherwise healthy children and adolescents is frequently caused by exercise induced asthma. Pediatrics 90(3) 350–353
Williams CL, Hayman LL, Daniels SR et al (2002) Cardiovascular health in childhood: a statement for health professionals from the committee on atherosclerosis, hypertension, and obesity in the young (AHOY) of the Council on Cardiovascular Disease in the Young, American heart association. Circulation 106:143–160
Zavaras-Angelidou KA, Weinhouse E, Nelson DB (1992) Review of 180 episodes of chest pain in 134 children. Pediatr Emerg Care 8(4):189–193
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Danduran, M.J., Earing, M.G., Sheridan, D.C. et al. Chest Pain: Characteristics of Children/Adolescents. Pediatr Cardiol 29, 775–781 (2008). https://doi.org/10.1007/s00246-008-9200-9
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DOI: https://doi.org/10.1007/s00246-008-9200-9