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Children’s health: chest pain in childhood CHILDREN’S HEALTH: CHEST PAIN IN CHILDHOOD
Chest pain is common during childhood. Although chest pain in adults can be serious, it is rarely a symptom of serious disease in children.
A very common form of chest pain in children is the so-called stitch in the side—a stabbing pain in the lower chest, more often on the left side than the right. This pain occurs with exercise and will stop after a minute or two of rest. This type of pain may be caused by gas pains in the large intestine, contraction of the spleen, or spasm of the diaphragm. Regardless of the cause, it is harmless.
Pain in the area of the sternum (breastbone) is common when a child has bronchitis or a head cold combined with a cough. A frequent, hard cough often makes the diaphragm sore, causing a pain just below the ribs. Pain on one side of the chest may be caused by pleurodynia (inflammation of the lining of the chest cavity) or by shingles.
Injuries (including muscle strains, bruises, and fractured ribs) cause pain that is worsened by deep breathing and movements of the chest. All of these types of chest pain are relatively minor and usually can be cared for at home.
There are a few causes of chest pain in children that are more serious, but these are also uncommon. Pleurisy that develops as a complication of pneumonia may cause chest pain; the pain is accompanied by other signs of pleurisy (fever, difficult breathing, cough).
Another more serious cause of chest pain is spontaneous pneumothorax, which is a bursting of a small bubble on the surface of the lung. When the bubble bursts, air escapes into the chest cavity, causing gradual collapse of the lung. This condition comes on suddenly, often with sharp pain, and causes increasing shortness of breath. A hernia of the diaphragm causes chest pain that is usually worse when lying down and less or absent when sitting and standing. Heart pain in children, even those with serious heart conditions, is so rare that it is practically unknown.
Signs and symptoms
Chest pain may occur alone or along with other symptoms. The exact location of the pain and the circumstances that bring on the pain or make it worse are clues to the type and cause of chest pain. Other symptoms (cough, fever, rash at the site of the pain, and shortness of breath) are also clues to the cause.
Home care
Most cases of minor chest pain can be treated at home with aspirin or paracetamol, mild heat, and reassurance. If chest pain is caused by a hard cough, cough medicines may help.
Pleurisy, spontaneous pneumothorax, and hernia of the diaphragm should be treated by a doctor.
Precautions
• If chest pain is accompanied by shortness of breath, high fever, a cough producing blood flecks, or prostration (collapse), get medical help immediately.
• If there is persistent pain beneath either armpit that is made worse by breathing, see your doctor.
• Do not give cough medicines if the child is having difficulty breathing.
Medical treatment
Your doctor may recommend X rays and blood tests. Pneumothorax is treated by hospitalization, close observation, and possibly a puncture of the chest wall to remove trapped air.
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