Selbst S M, Ruddy R, Clark B J
Emergency Department, Children's Hospital of Philadelphia, PA 19104.
Clin Pediatr (Phila). 1990 Jul;29(7):374-7. doi: 10.1177/000992289002900702.
During a 1-year period, 407 children with chest pain were seen in the Emergency Department of Children's Hospital of Philadelphia. Analysis of the clinical data of these children was reported previously. The authors successfully followed 149 of these children for 6 months or more, and 51 for 2 years or more. These patients returned for an average of 3.4 visits during the follow-up period. Thirty-four percent of the initial diagnoses were altered. Usually, during the follow-up period, the authors concluded that chest pain resulted from nonorganic causes. A new organic etiology was uncovered in only 12 of 149 cases. Only 1 child was found to have a heart abnormality (mitral valve prolapse), and 3 were found to have asthma. Chest pain did not resolve during the follow-up period in 43 percent of those followed. Children with chest pain should have follow-up care because of the persistence of symptoms, but serious disease is unlikely to be found over time.
在1年的时间里，费城儿童医院急诊科共接诊了407名胸痛患儿。此前已报道过对这些患儿临床资料的分析。作者成功随访了其中149名患儿6个月或更长时间，51名患儿2年或更长时间。在随访期间，这些患者平均复诊3.4次。最初诊断的34%被更改。通常，在随访期间，作者得出结论，胸痛是由非器质性原因引起的。在149例病例中，仅发现12例有新的器质性病因。仅发现1名儿童有心脏异常（二尖瓣脱垂），3名儿童患有哮喘。在接受随访的患儿中，43%的患儿胸痛在随访期间未缓解。由于症状持续存在，胸痛患儿应接受随访，但随着时间推移，不太可能发现严重疾病。
