Chest pain in a 12-year-old boy: when is it a harbinger of poor outcome?

Abstract

Chest pain is usually a benign presentation in children who present to emergency departments (ED) or primary care centers. Unlike adults, where chest pain is commonly due to cardiac causes, in children the cause is more likely secondary to non-cardiac causes. Here we present a case of a child known to have hyper-eosinophilic syndrome (HES) who presented with sudden onset of chest pain and had a rapidly progressive and fatal outcome in the ED. We discuss the ED approach to the child with chest pain and review acute myocardial infarction (AMI) in children.

Acute pain in myocardial infarction: analysis of concept

“…Most of the studies show that the sharp pain in myocardial infarction lasts 15 to 30 minutes (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) , followed by those that state the pain lasts up to 20 minutes (25)(26)(27)(28) .…”

“…In most publications (14)(15)(16)(17)(18)(22)(23)(25)(26)(33)(34)(35)(36)(37)(38)(39)(41)(42) , acute pain in myocardial infarction is located in the retrosternal region. Pain is frequently referred to as being in the retrosternal region and is presented through distressed precordial pain, irradiated to the left superior member, with great intensity and duration that shows no improvement and no relief with rest or sublingual nitrates.…”