Fogliazza Federica, Cifaldi Marina, Antoniol Giulia, Canducci Nicolò, Esposito Susanna
Pediatric Clinic, Department of Medicine and Surgery, University of Parma, Via Gramsci, 14, 43125 Parma, Italy.
J Clin Med. 2024 Nov 6;13(22):6659. doi: 10.3390/jcm13226659.
Chest pain in children and adolescents is a common reason for emergency department visits and referrals to pediatric cardiologists, often driven by parental concern about potential cardiac causes. However, the vast majority of pediatric chest pain cases are benign and non-cardiac in origin. This narrative review examines the etiology, evaluation, and management of pediatric chest pain, emphasizing the importance of a thorough clinical history and physical examination in distinguishing between benign and serious conditions. This review also explores the role of diagnostic tests such as electrocardiograms, chest radiography, and echocardiography, highlighting the need to balance the avoidance of unnecessary tests with the imperative to rule out life-threatening cardiac conditions. Despite the low prevalence of cardiac causes, the variability in diagnostic approaches underscores the need for standardized evaluation algorithms. These could streamline care, reduce unnecessary resource utilization, and minimize anxiety for both patients and their families. Future studies should focus on assessing the effectiveness of such algorithms in improving clinical outcomes and resource management. The findings underscore the importance of a careful, evidence-based approach to the management of pediatric chest pain.
儿童和青少年的胸痛是急诊就诊和转诊至儿科心脏病专家的常见原因，通常是由于家长担心潜在的心脏病因。然而，绝大多数儿科胸痛病例本质上是良性的且与心脏无关。这篇叙述性综述探讨了儿科胸痛的病因、评估和管理，强调了全面的临床病史和体格检查在区分良性和严重疾病方面的重要性。本综述还探讨了心电图、胸部X光和超声心动图等诊断测试的作用，强调需要在避免不必要检查与排除危及生命的心脏疾病的紧迫性之间取得平衡。尽管心脏病因的发生率较低，但诊断方法的差异凸显了标准化评估算法的必要性。这些算法可以简化医疗流程，减少不必要的资源利用，并最大限度地减少患者及其家属的焦虑。未来的研究应侧重于评估此类算法在改善临床结果和资源管理方面的有效性。研究结果强调了采用谨慎、基于证据的方法管理儿科胸痛的重要性。
