title: Analysis of clinical characteristics and causes of chest pain in children and adolescents.
abstract: OBJECTIVE
  Chest pain is common in children and adolescents and is a reason for referral to pediatric cardiologists. Although most cases of chest pain in these age groups are benign and do not require treatment, timely diagnosis is important not to miss life-threatening diseases requiring prompt treatment. We investigated certain clinical characteristics that may be useful in the diagnosis of such critical diseases.
  
  
  METHODS
  Patient medical records between July 2006 and September 2013 were retrospectively examined. We included 517 patients who presented with chest pain to the Department of Pediatrics at Kyung Hee University Hospital in Gangdong.
  
  
  RESULTS
  Most cases of chest pain were idiopathic in origin (73.6%), followed by cases with respiratory (9.3%), musculoskeletal (8.8%), cardiac (3.8%), gastrointestinal (2.9%), and psychiatric (1.4%) causes. In 6 patients (1.2%) with air-leak syndrome including pneumothorax or pneumomediastinum, the pain was abrupt, continuous, and lasted for a short period of 1-2 days after onset in the older adolescents. Of the patients with cardiac pain, 13 had cardiac arrhythmias (65.0%), 6 had congenital heart diseases (30%), and 1 had coronary aneurysms caused by Kawasaki disease (5.0%). One patient with atrial flutter had only symptoms of syncope and chest pain.
  
  
  CONCLUSIONS
  The abrupt, continuous chest pain of a short duration in the older children was characteristic of air-leak syndrome. In patients with pneumomediastinum, radiological diagnosis was difficult without careful examination. Combined syncope should not be neglected and further cardiac workup is essential in such patients.
authors.affiliation: Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Chun
authors.affiliation: Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors.forename: Tae Hyeong
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Korea.
authors.forename: Mi Young
authors.initials: MY
authors.lastname: Han
authors.affiliation: Department of Psychology, Chung Ang University, Seoul, Korea.
authors.forename: Na Yeon
authors.initials: NY
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
authors.forename: Kyung Lim
authors.initials: KL
authors.lastname: Yoon
keywords: Adolescent; Chest pain; Child; Musculoskeletal diseases