Chest pain in children, especially toddlers

The article was consulted professionally by Th.S BS. Dang Thi Ngoan – Doctor of Pediatrics - Neonatology - Vinmec Ha Long International General Hospital.

One thing parents should consider lucky is that heart attacks are unlikely at this age in children. However, chest pain in toddlers is worrisome and relatively common. In most cases, the cause of a child's chest pain is not heart-related and is not usually life-threatening. Here are the most common causes of chest pain in children:
Trauma or muscle strain. The bones or muscles in your baby's chest can hurt from a fall, bump, or when your baby is trying to lift a heavy object or when he's exercising or playing a sport that's too hard. Inflammation . Sometimes, the area between a child's breastbone and ribs can become inflamed, a condition also known as blepharitis. The child may feel pain when breathing, even in the area next to the breastbone. This usually happens after the child is sick with a virus or has a frequent cough. They can last for several weeks and require some anti-inflammatory medication such as ibuprofen. Asthma . If the culprit is asthma, in addition to chest pain, the child also has other symptoms such as a severe cough and difficulty breathing. Your child's symptoms may be more severe at night, early in the morning, and after running or crying. Pneumonia . If the chest pain is combined with other signs such as a persistent cough, the child may have pneumonia. Symptoms of pneumonia in addition to chest pain can include: shortness of breath, rapid breathing, irregular rhythm, wheezing, fever, chills, loss of appetite, abdominal pain, vomiting or even diarrhea. Stress or anxiety. If your child exhibits a dull ache in his chest when he's worried or upset about something, this could be directly related to stress. However, tension chest pain is more common in older children. Ingestion of foreign body. In the event that a child swallows something such as a toy, a coin or an oversized grape, he or she may feel a tightness in the chest due to the compression and irritation of the esophagus. Your baby may also cough, wheeze, or drool. Gastroesophageal reflux . If your baby complains of chest pain after eating, it may be the result of gastroesophageal reflux disease, especially in children who have a habit of lying down right after eating. In addition, the child will also feel a sore throat, have a sour taste in the mouth or even vomit.

Heart mimic syndrome. Although practically harmless, cardiac mimicry syndrome can cause severe attacks of pain in the left side of the chest, lasting only a few seconds or as long as a few minutes, and occurring several times a day. Scientists have not yet found the cause of this syndrome, but there are suggestions that it may be due to muscle spasticity or pinched nerves. Signs of puberty. For girls, breast pain can be an early sign of puberty as they begin to develop. A landmark study has shown that girls are showing worrying signs of precocious puberty. Experts also recommend that girls who hit puberty before the age of 8 need to be checked at medical facilities.

While it's rare that chest pain in toddlers comes from the heart, it can happen. According to a new study, about 2% of children and adolescents have signs of chest pain related to heart disease. Chest pain in children can be severe if:
The pain is very severe The pain persists for a long time The pain increases with activity, walking, or playing sports or exercise. Chest pain with fever, dizziness, trouble breathing, or fainting. Pain spreading to other parts of the body Meanwhile, heart-related problems that can lead to chest pain include:
Abnormal heart structure or vascular system Sometimes children are born with abnormalities heart disease due to genetics that it was not discovered until later, when growing up. Pericarditis, inflammation of the lining of the heart. It usually goes away on its own, but the cause of the condition may be something serious for the child. Myocarditis . The heart muscle becomes inflamed, reducing its ability to pump blood. This can have many causes, including infections and reactions to medications. Kawasaki disease. An illness that causes blood vessels to become inflamed, often accompanied by a high fever and flaky skin. The disease usually appears in children under 5 years of age, can be treated when detected early, and most children with this disease can be cured. Abnormal heart rate. Irregular heartbeats are common in toddlers and they're usually not something to worry about. However, in rare cases, an abnormal heart rhythm in a child can be caused by a pre-existing medical condition.

This completely depends on the severity of the child's illness. Even in many cases, parents should consider calling an ambulance if their child has chest pain and is having trouble breathing.
The doctor should be called if the child's chest pain is accompanied by other symptoms and the mother thinks their child may have pneumonia, asthma or GERD. In addition, children should also be taken to medical facilities for examination in case they suspect they have swallowed a foreign body or suspect that chest pain is related to heart problems.
If the child seems fine except for the chest pain and the pain goes away quickly, it is probably not a concern. Parents do not need to call the doctor or take the child to a medical facility, but simply monitor the child that day and a few days later.

To diagnose chest pain, doctors will:
Do a general examination of your baby's chest. Use a stethoscope to examine the chest. This way, doctors can determine if the pain is coming from the chest wall (ribs, muscles, or skin) or from organs inside the chest like the heart or lungs. Indications for chest X-ray in cases where the general examination does not yield results. A chest X-ray can help doctors see if a child has pneumonia or has swallowed a foreign body. Once the cause of the pain is diagnosed, the doctor can prescribe the appropriate treatment. For example, if your child has bacterial pneumonia, the doctor will prescribe antibiotics. If your baby's chest pain is severe or persists for a long time, the doctor may refer the child to a cardiologist.

This depends on the underlying cause of the chest pain in your child. For people with mild chest pain, parents can:
Reassure the child. If the chest pain lasts only a few seconds or minutes, reassurance to make the child less afraid may be all that parents need to do.

Pain relief. If the pain persists (for example, due to muscle pain), mothers can give their babies acetaminophen or ibuprofen to help. Place a heating pad or warm towel on the child's chest. This can ease the pain and help your baby feel more comfortable. There are many reasons why a child may have chest pain. Many causes of chest pain do not last long and are not life-threatening for your baby. However, there are some conditions where chest pain is a sign of a more serious condition and needs a careful diagnosis from a doctor. Parents need to be very alert and not subjective to any signs that the child has chest pain and in case the pain does not show any sign of ending, it is necessary to immediately take the child to the nearest medical facility.
As a key area of ​​Vinmec Health system, Pediatrics Department always brings satisfaction to customers and is highly appreciated by industry experts with:
Gathering a team of top doctors and nurses in Pediatrics : consists of leading experts with high professional qualifications (professors, associate professors, doctorates, masters), experienced, worked at major hospitals such as Bach Mai, 108.. Doctors All doctors are well-trained, professional, conscientious, knowledgeable about young psychology. In addition to domestic pediatric specialists, the Department of Pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) who are always pioneers in applying the latest and most effective treatment regimens. . Comprehensive services: In the field of Pediatrics, Vinmec provides a series of continuous medical examination and treatment services from Newborn to Pediatric and Vaccine,... according to international standards to help parents take care of their baby's health from birth to childhood. Advanced techniques: Vinmec has successfully deployed many specialized techniques to make the treatment of difficult diseases in pediatrics more effective: neurosurgery - skull, stem cell transplant blood in cancer treatment. Professional care: In addition to understanding children's psychology, Vinmec also pays special attention to the children's play space, helping them to play comfortably and get used to the hospital's environment, cooperate in treatment, improve the efficiency of medical treatment. If you have a need for medical examination with experienced pediatricians at Vinmec, please make an appointment on the website to be served.

Reference sources: babycenter.com, healthline.com