Chest Pain in Pediatrics

Kocis, Keith C.

doi:10.1016/s0031-3955(05)70112-7

Cited by 67 publications

(58 citation statements)

References 70 publications

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“…Kocis 34 gives a detailed list for different diagnoses in children with chest pain. Pectoralis Major and Minor muscles are the most important muscular pains included within this list.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the functional capacity, respiratory functions and musculoskeletal systems of the children with chest pain for non-cardiac reasons

Daşkapan¹,

Sanli²,

Aydoğan-Arslan³

et al. 2017

Turk J Pediatr

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Chronic chest pain in healthy children and adolescents generally arises from non-cardiac factors. The purpose of our study was to compare the evaluation results of effort test, respiratory function and musculoskeletal system in children and adolescents with chest pain for non-cardiac reasons with healthy children and adolescents. Physical activity level was determined by the International Physical Activity Questionnaire. The respiratory function test was performed using a spirometer. The posture analysis was performed to determine the upper body deformities. The effort test was performed on a treadmill. The two groups were similar in terms of the physical activity levels, respiratory function and effort test results (p>0.05). The rate of the rounded shoulder, kyphosis was significantly higher in the patient group with chest pain (p<0.005). Consequently, the musculoskeletal system findings including the pectoralis minor shortness, rounded shoulder, and thoracic kyphosis could have a role in non-cardiac chest pain.

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“…Kocis 34 gives a detailed list for different diagnoses in children with chest pain. Pectoralis Major and Minor muscles are the most important muscular pains included within this list.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the functional capacity, respiratory functions and musculoskeletal systems of the children with chest pain for non-cardiac reasons

Daşkapan¹,

Sanli²,

Aydoğan-Arslan³

et al. 2017

Turk J Pediatr

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“…The evaluation is often resource intensive and costly despite the low incidence of cardiac pathology ranging from 0% to 5%. [1][2][3][4][5][6][7][8][9][10][11][12][13] This low incidence has been documented in the emergency setting as well as ambulatory care. 14 Many previous reports on pediatric chest pain have been observational and lack guideline recommendation.…”

mentioning

confidence: 99%

Regional Implementation of a Pediatric Cardiology Chest Pain Guideline Using SCAMPs Methodology

et al. 2013

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BACKGROUND AND OBJECTIVES: Chest pain is a complaint for which children are frequently evaluated. Cardiac causes are rarely found despite expenditure of considerable time and resources. We describe validation throughout New England of a clinical guideline for cost-effective evaluation of pediatric patients first seen by a cardiologist for chest pain using a unique methodology termed the Standardized Clinical Assessment and Management Plans (SCAMPs). METHODS: A total of 1016 ambulatory patients, ages 7 to 21 years initially seen for chest pain at Boston Children’s Hospital (BCH) or the New England Congenital Cardiology Association (NECCA) practices, were evaluated by using a SCAMPs chest pain guideline. Findings were analyzed for diagnostic elements, patterns of care, and compliance with the guideline. Results from the NECCA practices were compared with those of Boston Children’s Hospital, a regional core academic center. RESULTS: Two patients had chest pain due to a cardiac etiology, 1 with pericarditis and 1 with an anomalous coronary artery origin. Testing performed outside of guideline recommendations demonstrated only incidental findings. Patients returning for persistent symptoms did not have cardiac disease. The pattern of care for the NECCA practices and BCH differed minimally. CONCLUSIONS: By using SCAMPs methodology, we have demonstrated that chest pain in children is rarely caused by heart disease and can be evaluated in the ambulatory setting efficiently and effectively using minimal resources. The methodology can be implemented regionally across a wide range of clinical practice settings and its approach can overcome a number of barriers that often limit clinical practice guideline implementation.

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“…Musculoskeletal causes are common, and often related to trauma. Other non-traumatic diagnoses associated with chest pain are pneumothorax, pleurisy, myocarditis, pericarditis, and pleurodynia (Kocis 1999). Pain at night was reported by only 1 patient-a symptom often considered typical of bone malignancies.…”

Section: Discussionmentioning

confidence: 99%

Ewing sarcoma of the rib—initial symptoms and clinical features: Tumor missed at the first visit in 21 of 26 patients

Widhe

Bauer

2007

Acta Orthopaedica

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Background and purpose Doctor's delay in diagnosing Ewing sarcoma is often long. We examined the initial symptoms of Ewing sarcoma of the rib to find characteristics that could help to shorten the delay in diagnosis and hopefully influence the prognosis.Patients and methods We examined the records from the first visit for symptoms related to Ewing sarcoma of the rib in 26 consecutive patients, all of whom were < 30 years of age and had been diagnosed between 1981 and 2000. All patients had a minimum of 5 years follow-up.Results A tumor was suspected at the first visit in only 5 of the 26 patients; pleurisy was the most common misdiagnosis. 23 patients complained of pain, localized or pleuritic, and 11 had a palpable mass. 15 of the 26 patients had chest radiographs taken at the first visit, but a tumor was suspected in only 4 cases. The most common radiographic finding was pleural effusiondiagnosed in 10 of the 15 patients. 23 patients were operated. It is noteworthy that in 6 patients no tumor was suspected before surgery. 12 patients died from the Ewing sarcoma. Median survival was 2.4 years. Doctor's delay was median 3.0 (0-10) months, but it exceeded 7 months in 4 patients. Patient's delay was 2.5 (0-10) months.Interpretation The most important clinical finding in Ewing sarcoma of the rib was a palpable mass and pleural effusion. Both findings are rare in this age group and should be thoroughly investigated.

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Chest Pain in Pediatrics

Cited by 67 publications

References 70 publications

Evaluation of the functional capacity, respiratory functions and musculoskeletal systems of the children with chest pain for non-cardiac reasons

Evaluation of the functional capacity, respiratory functions and musculoskeletal systems of the children with chest pain for non-cardiac reasons

Regional Implementation of a Pediatric Cardiology Chest Pain Guideline Using SCAMPs Methodology

Ewing sarcoma of the rib—initial symptoms and clinical features: Tumor missed at the first visit in 21 of 26 patients

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