Cardiac chest pain in children.

OBJECTIVE

Chest pain (CP) is a common cause of referral to hospital, not always directly related with cardiac diseases (CD). We investigated the causes for cardiac CP in children.

METHODS

A hundred and twenty children, admitted consecutively to pediatric cardiology clinic with CP, were evaluated in two groups (5-12 and 13-16 age-group) in a cross-sectional and a retrospective way. Chest X-ray, electrocardiography, and echocardiography were performed. In case of necessity, 24-hour Holter monitoring, exercise stress test, tilt-table test were performed, and hemogram, serum glucose, electrolytes were evaluated. Statistical analysis was performed using Chi-square test and risk ratio [(Odds-ratio (OR, (95% CI)] in groups were evaluated.

RESULTS

Most children with CP were older. Cardiac diseases were established in 52 (42.5%) patients. Cardiac diseases, which may cause CP (aortic stenosis, mitral valve prolapse, arrhythmias, etc.) were found in 23.3% (n=28) of patients. Compared with the younger, the risk of structural CD was found to be 2.84 times higher (OR=2.84, 95%CI 1.24-6.48, p=0.011) and risk of arrhythmia was 3.53 times higher in the elder age group (OR=3.53, 95%CI 0.93-13.38, p=0.051). When all CD were evaluated, elder children were found to have 4.12 times more risk of having CD (OR=4.12, 95%CI 1.89-9.01, p<0.0001).

CONCLUSION

Most children with CP were older than 12 years old. CDs were frequent and about half of them were thought to directly cause pain. So, further investigations according to standard algorithms are needed in the evaluation of children with CP. Other important result is the increased risk of CD found in elder children.