Follow-up study of patients admitted to the pediatric emergency department for chest pain

Fregolent, Davide; Contorno, Sarah; Tamaro, G.; Barbi, Egidio; Cozzi, Giorgio

doi:10.1007/s00431-019-03495-5

Cited by 20 publications

(27 citation statements)

References 25 publications

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“…Although some studies have reported that children presenting with chest pain are usually female with a mean age of around 10 years, 13,19 other studies indicated higher presentation in males or females over 12 years of age and in pubertal children. 3,8,[20][21][22] In the present study, there were more females and children >12 years of age. Such differences probably originate from the characteristics of different studies.…”

Section: Discussionmentioning

confidence: 94%

“…In previous studies, the incidence of cardiac diseases in children with chest pain has varied between 0.6 and 9.27%. 6,8,[12][13][14][15][16][17] The incidence and the types of cardiac diseases vary greatly based on the type of centre (i.e., emergency department, primary care or paediatric cardiology outpatient clinic). Saleeb et al 14 reported that there were only 37 cardiac causes in a cohort of 3700 patients from a children's hospital, corresponding to a rate of 1%.…”

Section: Discussionmentioning

confidence: 99%

“…In young children, pain evaluation and ruling out cardiac diseases necessitate the use of resource-intensive procedures as their description and localisation of chest pain are generally not very accurate. 8 In addition to the admission of children with chest pain to paediatric cardiology departments, prompt referral to a paediatric cardiologist is usually needed in patients who are evaluated at emergency departments or primary-care facilities. 7,8 However, there have been few studies that investigated the outcome in patients with chest pain who were admitted or referred to a paediatric cardiology unit.…”

mentioning

confidence: 99%

“…8 In addition to the admission of children with chest pain to paediatric cardiology departments, prompt referral to a paediatric cardiologist is usually needed in patients who are evaluated at emergency departments or primary-care facilities. 7,8 However, there have been few studies that investigated the outcome in patients with chest pain who were admitted or referred to a paediatric cardiology unit. 7,9 In this study, we aimed to investigate the distribution of diseases underlying chest pain in children and adolescents to understand the clinical characteristics of children with chest pain referred to a paediatric cardiology outpatient clinic.…”

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confidence: 99%

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Aetiological evaluation of chest pain in childhood and adolescence

et al. 2020

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Background:Chest pain, as a common cause of hospital admissions in childhood, necessitates detailed investigations due to a wide range of differential diagnoses. In this study, we aimed to determine the distribution of diseases causing chest pain in children and investigate the clinical characteristics of children with chest pain.Methods:This study included 782 patients aged between 3 and 18 years who presented to a paediatric cardiology outpatient clinic with chest pain between April 2017 and March 2018. Aetiological causes and demographic features of the patients were analysed.Results:Most prevalent causes of chest pain were musculoskeletal system (33%) and psychogenic (28.4%) causes. Chest pain due to cardiac reasons was seen in eight patients (1%). Diseases of musculoskeletal and gastrointestinal systems and psychogenic disorders were significantly more common in male and female patients, respectively (p < 0.001 for all). In winter, patients’ age and the number of patients with ≥12 years were higher than those in other seasons (p < 0.001). Most of the parents (70.8%) and patients (90.2%) thought that chest pain in their children was caused by cardiac causes.Conclusion:Most of the diagnoses for chest pain in childhood period are benign and include the musculoskeletal system and psychogenic diseases. Although chest pain due to cardiac diseases is rare, a comprehensive analysis of medical history, detailed physical examination and cardiac imaging with echocardiography is needed to reach more accurate diagnoses.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

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Aetiological evaluation of chest pain in childhood and adolescence

et al. 2020

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“…Chest pain is a common complaint at pediatric clinics, accounting for ∼6 per 1,000 visits at pediatric emergency room (1), as well as ∼1 per 40 visits at pediatric clinics in the UK (2), To date, no large studies have been conducted to investigate this topic in Chinese children. In adults, chest pain is often caused by severe cardiovascular diseases, while in children, chest pain is mostly benign and rarely cardiac (3)(4)(5)(6)(7)(8)(9)(10)(11). In China, however, most parents believe that chest pain in children is cardiac and life-threatening.…”

Section: Introductionmentioning

confidence: 99%

The Causes of Chest Pain in Children and the Criteria for Targeted Myocardial Enzyme Testing in Identifying the Causes of Chest Pain in Children

Chen

Duan

et al. 2021

Front. Cardiovasc. Med.

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Aims: Chest pain is a common complaint at pediatric cardiology clinics and often leads to an extensive cardiac evaluation. In this study, we analyzed the causes of chest pain in Chinese children and developed diagnostic procedures and criteria for targeted myocardial enzyme testing.Methods and Results: We retrospectively analyzed the clinical data of patients aged below 18 years visiting our hospital for chest pain between 2005 and 2019. Based on auxiliary exams and clinical diagnosis, we developed diagnostic procedures and criteria for targeted myocardial enzyme testing in children with chest pain. A total of 7,251 children were included in this study. The chest pain was of cardiac origin in 581 patients (8.0%). The incidence of non-cardiac chest pain was significantly higher in the preschool group and the school-age group than in the adolescent group (93.5 vs. 93.8 vs. 90.3%, P < 0.05). Among children with cardiac chest pain, the most common concomitant symptom was chest tightness (67.0%). Myocardial enzyme testing was performed in 5,408 patients and was abnormal in 453 patients. We developed a diagnostic procedure and criteria for targeted myocardial enzyme testing using pertinent history, physical examination, and ECG findings or UCG finding. Applying the diagnostic procedure and criteria could lead to the reduction in myocardial enzyme testing while still capturing all cardiac diagnoses.Conclusion: In children, chest pain is mostly benign and rarely cardiac. During diagnosis, targeted myocardial enzyme testing based on medical history and physical examination can effectively reduce resource use.

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