Chest Pain

Definition

  • Pain or discomfort in the chest (front or back). This includes the area from the lower neck to the bottom of the rib cage. Causes: Most persistent chest pain is from a hacking cough. Coughing can cause sore muscles in the chest wall, upper abdomen or diaphragm. Occasionally, chest pain follows strenuous exercise, lifting (e.g. weights or heavy boxes), or work that involves the upper body (e.g. digging). This type of muscle soreness often increases with movement of the shoulders. Most brief chest pain lasting minutes is from harmless muscle cramps or a pinched nerve (called precordial catch syndrome). Heart disease is hardly ever the cause of chest pain in children.

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Call 911 Now (your child may need an ambulance) If

  • Severe difficulty breathing (struggling for each breath, grunting to push air out, unable to speak or cry or lips are bluish)

Call Your Doctor Now (night or day) If

  • Your child looks or acts very sick
  • Your child has heart disease
  • Difficulty breathing, but not severe
  • Can't take a deep breath
  • Severe chest pain
  • Heart beating very rapidly or has fainted
  • Followed a direct blow to the chest
  • Unexplained chest pain present > 1 hour
  • (EXCEPTION: pain due to coughing, sore muscles or other obvious cause)

Call Your Doctor Within 24 Hours (between 9 and 4) If

  • You think your child needs an office visit
  • Fever is present

Call Your Doctor During Weekday Office Hours If

  • Sore muscles last > 7 days
  • Chest pains are a recurrent problem

Parent Care at Home If

  • Normal chest pain from sore muscles and you don't think your child needs to be seen

Home Care Advice for Chest Pain from Sore Muscles

  1. Reassurance: Chest pains in children lasting for a few minutes are usually harmless muscle cramps. They need no treatment. Chest pains from vigorous exercise of the upper body (sore muscles) usually start soon after the activity and need the following treatment.
  2. Pain Medicine: Give acetaminophen or ibuprofen. Continue this until 24 hours have passed without pain.
  3. Local Heat: Apply local heat for 20 minutes 4 times a day. Use a heating pad or warm washcloth to the area.
  4. Stretching Exercises:
  5. Expected Course: Daily, gentle stretching exercises of the shoulders and chest wall in sets of 10 twice daily can prevent recurrence of these chest pains. Stretching exercises can be continued even during active chest pain. Avoid any exercise that increases the pain.
  6. Call Your Doctor If
    • Pains last > 7 days on treatment
    • Your child becomes worse or develops any of the "Call Your Doctor Now" symptoms