title: Effectiveness of screening for life-threatening chest pain in children.
abstract: OBJECTIVE
  We sought to determine the incidence of sudden cardiac death among patients discharged from the cardiology clinic with presumed noncardiac chest pain (CP).
  
  
  METHODS
  The records of children >6 years of age who presented to Children's Hospital Boston between January 1, 2000, and December 31, 2009, with a complaint of CP were reviewed for demographic features, clinical characteristics, resource utilization, and presumed diagnosis. Patients were searched for in the US National Death Index and Social Security Death Index.
  
  
  RESULTS
  Data for a total of 3700 patients with CP (median age at evaluation: 13.4 years [range: 7-22.3 years]) were reviewed. The median follow-up period was 4.4 years (range: 0.5-10.4 years), for total of 17 886 patient-years of follow-up data. CP with exertion occurred in 1222 cases (33%), including 15 with associated syncope. A cardiac cause was determined in 37 cases; the remaining 3663 patients (99%) had CP of unknown (n = 1928), musculoskeletal (n = 1345), pulmonary (n = 242), gastrointestinal (n = 108), anxiety-related (n = 34), or drug-related (n = 4) origin. Emergency department visits for CP were documented for 670 patients (18%), and 263 patients (7%) had cardiology follow-up visits related to CP. There were 3 deaths, including 2 suicides and 1 spontaneous retroperitoneal hemorrhage.
  
  
  CONCLUSIONS
  CP in children is a common complaint and rarely has a cardiac cause. Review of 1 decade of cardiology visits (nearly 18 000 patient years) revealed that no patient discharged from the clinic died as a result of a cardiac condition.
authors: Department of Cardiology, Children's Hospital Boston and Harvard Medical School, Harvard University, Boston, MA 02115, USA. susan.saleeb@cardio.chboston.org
authors: Susan F
authors: SF
authors: Saleeb
authors: Wing Yi V
authors: WY
authors: Li
authors: Shira Z
authors: SZ
authors: Warren
authors: James E
authors: JE
authors: Lock
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002637:Chest Pain / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D015331:Cohort Studies; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D015150:Echocardiography, Doppler / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005080:Exercise Test / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006776:Hospitals, Pediatric; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008991:Monitoring, Physiologic / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis; D013997:Time Factors; D055815:Young Adult