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.
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
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
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.
Pain Medicine: Give acetaminophen or
ibuprofen. Continue this until 24 hours have passed without pain.
Local Heat: Apply local heat for 20 minutes 4 times a day. Use a heating pad or warm washcloth to the area.
Stretching Exercises:
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 that increase the pain.
Call Your Doctor If
Pains last > 7 days on treatment
Your child becomes worse or develops any of the “Call Your Doctor” symptoms
