Etiology of Chest Pain in Children

Abstract

Çocuklardaki göğüs ağrıları genellikle organik bir neden olmadan gelişmekte, yakınma süresi uzadıkça da neden bulma olasılığı azalmaktadır. Erişkinlerden farklı olarak kalp hastalıklarından kaynaklanan göğüs ağrıları çocuklarda ender olarak görülmektedir. Diğer yandan, göğüs ağrısına yol açabilen kalp hastalıklarının çoğunluğu hayati önemi olan, ani ölüm tehlikesi bulunan durumlardır (2). Bu nedenle çocuklarda göğüs ağrısı GİRİŞ Çocuklarda göğüs ağrısı hastanelere sık başvuru nedenlerinden biridir. Erişkinlerden farklı olarak çocukluk dönemindeki göğüs ağrılarının kardiyak kökenli olma olasılığı düşüktür. Ancak aileler tarafından ağrının kalp ağrısı olabileceğinin düşünülmesi, aileyi ve çocuğu endişelendirmekte, bu da konunun aydınlatılmasını ve ailenin bilgilendirilmesini önemli hale getirmektedir (1,2). ÖzET Amaç: Hastanemize göğüs ağrısı yakınması ile başvuran çocukların etiyolojik açıdan incelenmesi ve en sık karşılaşılan sebeplerin belirlenmesi hedeflenmiştir. Gereç ve Yöntemler: Çalışma kapsamında hastanemize Aralık 2010 ile Temmuz 2011 tarihleri arasında göğüs ağrısı yakınması ile başvuran 603 olgu geriye dönük olarak incelendi. Bulgular: Çalışma grubundaki hastaların %46.8'i kız, %53.2'si erkekti. Hastaların yaş ortalaması 11.8 ± 2.7 (5.5-18) yıldı. Hastaların %46.9'unda kas iskelet sistemi, %17.5'inde kardiyovasküler sistem, % 5.1'inde solunum sistemi, %3.3'ünde gastrointestinal sistem, %3'ünde psikojenik nedenli göğüs ağrısı tespit edildi. %21.4'ünde ise göğüs ağrısının nedeni bulunamadı ve idiyopatik göğüs ağrısı olarak değerlendirildi. Hastaların %2.8'inde göğüs ağrısının nedeni kollajen doku hastalığı, Marfan sendromu, meme büyümesi ve zona gibi diğer nedenlere bağlandı. Sonuç: Çocuklardaki göğüs ağrısının ayrıntılı araştırılması gerekliliği sonucuna varılmıştır. ABSTrAcTObjective: We aimed to examine the etiology of chest pain in children and to clarify the most common causes in this study. Material and Methods:A total of 603 patients who applied to our hospital with chest pain between December 2010 and July 2011 were retrospectively reviewed. results:The female and male percentages of the study group were 46.8% and 53.2% respectively. The mean age of the patients was 11.8 ± 2.7 (5.5-18) years. The etiology of the chest pain was related to the musculoskeletal system in 46.9%, the cardiovascular system in 17.5%, the respiratory system in 5.1%, and the gastrointestinal system in 3.3% and was psychogenic in 3%. No etiology was found in 21.4% of the patients and they were considered to be idiopathic. Other diagnoses such as connective tissue disease, Marfan syndrome, breast swelling and herpes zoster were present in 2.8% of the patients and these were classified as miscellaneous. conclusion:Chest pain in children should be investigated carefully.

Evaluation of Children and Adolescents Admitted to the Emergency Department with Complaints of Chest Pain

“…While psychogenic or stress-related CP is more common among adolescents while cardiorespiratory CP resulting from asthma, pneumonia or cardiac disorders is more common in younger children. In Turkey, psychogenic factors are reported in 3-10% of children presented with CP (3,13,23). In our study, CP frequency was 10.2% and was more common among adolescent girls.…”

“…In our study, musculoskeletal pathologies were the most common cause of CP in agreement with literature. The factors which are helpful in diagnosis include worsening pain with breathing or activity, relief of pain with removal of triggering event and lack of abnormal finding in the physical examination (13)(14)(15). Costochondritis, exercise, overuse of chest muscles by cough, trauma, slipping rib syndrome, herpes zoster, pleurodynia, Tietze's syndrome and chest wall and vertebral anomalies can cause CP (10,16).…”

“…In a study by Sert et al (3) it was reported that respiratory CP incidence was 6.6% among children, 28% of which were asthma. Öztürk et al (13) reported that 5.1% of all CP cases originated from respiratory system, 58% of which were diagnosed as asthma. In our study, respiratory CP comprised 5.3% of all cases with CP; of these, 56.3% were asthma and 43.7% were pneumonia.…”

Pain and factors that affect its definition as defined by preschool age children: a qualitative study

“…The perception of pain is complex and affected by many factors. In the literature, factors such as age, gender, cultural features, religion, personality, depression, experiences, and vulnerability to pain are reported to affect the definition of pain (5)(6)(7) .…”

“…Injuries such as cuts and bruises that occur while playing, sore throats caused by tonsillitis, and post-injection pain after a routine vaccination can be regarded as examples of pain. Pain epidemiology finds that abdominal and chest pain is common for children (6) , and this knowledge is particularly important for young children who cannot express their symptoms precisely because pain indicates physical problems.…”