title: Clinical characteristics and causes of chest pain in 380 children referred to a paediatric cardiology unit.
abstract: BACKGROUND
  Chest pain is a common presenting complaint to paediatrics, paediatric cardiology, and paediatric emergency departments. In this study, we prospectively evaluated clinical characteristics and causes of chest pain in children referred to our paediatric cardiology unit.
  
  
  METHODS
  A total of 380 children were included. Associated symptoms and past and family histories were evaluated. All patients underwent physical examination. The following studies were performed: complete blood count in all patients; fasting lipid profiles in overweight and obese children and children with a family history of premature cardiovascular disease; and electrocardiogram, chest X-ray, and echocardiogram in all patients. If necessary, 24-hour electrocardiogram monitoring or exercise stress tests were performed. Patients with a history of positive psychological findings were evaluated by a child psychiatrist.
  
  
  RESULTS
  The most common causes of chest pain were musculoskeletal disorders (37.1%), idiopathic chest pain (29.2%), and miscellaneous disorders, for example precordial catch syndrome (15%), respectively. Only 1 of 380 (0.3%) patients had chest pain due to a cardiac disorder. Electrocardiograms were abnormal in 4 of 380 (1.1%) patients. A total of 9 of 380 patients (2.3%) had dyslipidaemia.
  
  
  CONCLUSIONS
  Although a paediatric cardiology referral may provide reassurance to the primary care and emergency department physicians, our results show that cardiac aetiologies for paediatric chest pain are very rare. We think that many patients in our study were adequately evaluated only by careful history, and physical examination. Therefore, we suggest that it may not be necessary to use echocardiogram in the routine evaluation of children with chest pain.
authors.affiliation: Department of Pediatric Cardiology, Konya Training and Research Hospital, Konya, Turkey. ahmetsert2@hotmail.com
authors.forename: Ahmet
authors.initials: A
authors.lastname: Sert
authors.forename: Ebru
authors.initials: E
authors.lastname: Aypar
authors.forename: Dursun
authors.initials: D
authors.lastname: Odabas
authors.forename: Cem
authors.initials: C
authors.lastname: Gokcen
mesh_terms: D000293:Adolescent; D002637:Chest Pain / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012017:Referral and Consultation