Implementation of a Pediatric Chest Pain Local Consensus Guideline Decreases the Total Tests Performed Without Negatively Affecting the Yield of Abnormal Cardiac Results

Powell, Adam W.; Pater, Colleen; Chin, Clifford; Wittekind, Samuel G.; Mays, Wayne A.; Anderson, Jeffrey B.; Statile, Christopher

doi:10.1007/s00246-020-02414-y

Cited by 2 publications

(1 citation statement)

References 13 publications

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“…The way parents react to their child's pain can influence its perceived severity. For example, a parent's protective response to a child's chest pain may increase the anxiety of the child and thereby exacerbate the pain [ 9 , 10 ]. Chest pain in children can also be caused by minor or severe trauma.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of chest pain among children presenting to the pediatric emergency department

Al Ghadeer,

Alnaim,

AlGarni

et al. 2023

JMedLife

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Chest pain in pediatric patients is a common concern in pediatric emergency departments (ED). In most cases, benign conditions are related to noncardiac causes, and only a minority of the cases are caused by heart disease. This research aimed to evaluate the causes and characteristics of chest pain among children in a pediatric emergency department. This retrospective study evaluated children younger than 14 years of age who presented to the emergency department of a general pediatric hospital in the Eastern area of Saudi Arabia with non-traumatic chest pain between 2017 and 2022. The data included socioeconomic information, physical examination findings, and the results of basic investigations, such as chest X-ray and electrocardiogram. The Chi-square test was performed to compare various etiologies, with a 5% significant level. The study evaluated 310 patients with a mean age of 9.1±2.7 years. The majority of children presenting with chest pain had normal physical examinations, except 3.3% who showed respiratory and cardiac findings. The diagnostic tests indicated pneumonia in 2.9% and arrhythmia in 2.1% of children. Most patients were discharged with a diagnosis of idiopathic or muscular chest pain. The majority of patients (95%) were treated symptomatically in outpatient settings, with just one patient requiring hospitalization. The most common cause of chest pain prompting a child to visit the ED was idiopathic chest pain. Therefore, this study highlights the significance of obtaining a comprehensive medical history and physical examination to reveal important clues and help avoid unnecessary tests.

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Section: Introductionmentioning

confidence: 99%

Characteristics of chest pain among children presenting to the pediatric emergency department

Al Ghadeer,

Alnaim,

AlGarni

et al. 2023

JMedLife

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Persistent Elevation of Troponin I in a Pediatric Patient Resulting From Macrotroponin Complex

Harberg¹,

Al-Mousily²,

Akter

et al. 2023

Pediatrics

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Although chest pain is a common chief complaint among pediatric patients, cardiac pathology historically has accounted for a small percentage of cases. However, the emergence of COVID-19 and particularly its potential for leading to multisystem inflammatory syndrome has changed the threshold for the evaluation of cardiac etiologies of chest pain. This evaluation often includes measurement of the serum cardiac troponin I level. We present a case of a 16-year-old male athlete who presented to an outside emergency department with chest pain and was found to have elevated serum troponin I levels. Despite sports restriction, his troponin level remained elevated for months in the absence of other clinical findings and he was subsequently referred to our outpatient pediatric cardiology clinic. Further laboratory evaluation revealed that, in addition to troponin I, the assay measured an immune complex of uncertain significance formed by anti-troponin I antibodies bound to troponin I, known as macrotroponin. Delayed clearance of this complex from the bloodstream can result in overestimation of troponin I levels that can affect clinical management and create anxiety for our patients and their families. Macrotroponin complex deserves increased recognition among the research and clinical communities, especially in the pediatric realm.

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Implementation of a Pediatric Chest Pain Local Consensus Guideline Decreases the Total Tests Performed Without Negatively Affecting the Yield of Abnormal Cardiac Results

Cited by 2 publications

References 13 publications

Characteristics of chest pain among children presenting to the pediatric emergency department

Characteristics of chest pain among children presenting to the pediatric emergency department

Persistent Elevation of Troponin I in a Pediatric Patient Resulting From Macrotroponin Complex

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