Pediatric Cardiologist, Amirkabir Hospital, Arak University of Medical Sciences, Arak, Iran.
Department of emergency, School of Medicine, Arak University of Medical Sciences, Arak, Iran.
General Practitioner, Department of emergency, School of Medicine, Arak University of Medical Sciences, Arak, Iran.
Department of Biostatistics and Epidemiology, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
Background: Chest pain is one of the common chief complaints in children which can be benign and or life-threatening. In this retrospective study, the causes of chest pain, associated factors, and clinical characteristics in children have been evaluated in order to have a better diagnosis and clinical approach.
Methods: We designed prospective descriptive study from Jan 2017 to July 2019.680 patients with chest pain were referred to the pediatric cardiology clinic whose 500 patients were evaluated. All the information about past medical history, family history, chest pain characteristics, and associated symptoms were collected and all the body systems were examined. The patients who were suspected to psychological problems were referred to psychiatrists for evaluation. The data were indicated as counts and percentages. Statistical analyses were performed using SPSS (version 16).
Results: We studied 250 boys and 250 girls. The mean age of the girls and boys were 10.32 ±4.95 and 10.11 ± 5.13 years respectively. The mean weight and height of children were 32.73 ± 10.16 kilograms and 138.32 ±14.02 centimeters respectively. The mean BMI was 16.55 ± 3.14 kg/m2. The mean systolic and diastolic blood pressures were 89 ±11.32 mmHg and 68.2 ±8.12 mmHg respectively. The most frequently reported symptoms accompanied with chest pain were palpitation and exertional dyspnea. 111 patients had abnormal echocardiography and 32 of them had abnormalities in ECG. Dyslipidemia was detected in one of the obese children. The most common causes of chest pain were idiopathic 212 (42.4%), cardiac origins 111 (22.2%), musculoskeletal 69 (13.8%), psychiatric problems 43 (8.6%), gastrointestinal 33 (6.6%), respiratory 28 (5.6%), and gynecomastia 4 (0.08%) respectively. Cardiac chest pain was the most common type among the children between 15 to 18 years old. The p-value of mean difference was (P=0.785) for age, was (P=0.398) for weight, was (P=0.455) for height, was (P=0.164) for SBP, was (P=0.249) for DBP, and was (P=0.571) for BMI.
Conclusions: The causes of chest pain could be diagnosed by history-taking, physical exams, and cardiac auscultation. Further tests such as echocardiography, ECG, CXR, and laboratory tests were not essential to diagnose cardiac pains as the first line evaluation.