小児科と治療学
オープンアクセス

概要

Chest Pain in Children

Abdulmajid Mustafa Almawazini *,Ali S D Alghamdi ,Ahmed M Alzahrani ,Ali A Al Sharkawy ,Aymen A Alfeky

Objectives: Chest pain (CP) is a common cause of referral the children to Hospital. The objective of this study is to describe current magnitude, causes, rate of cardiac chest pain, associated risk factors, and what is the ideal approach for this group of patients in pediatric emergency department and cardiology unit in.

Patients and methods: this is prospective hospital based cross sectional study done in Pediatric Department, King Fahad Hospital Albaha Kingdom of Saudi Arabia from Jan 2010 till Jan 2013. The patients are aged from 5 to 12 year. A chest pain protocol was performed by Pediatrician on every patient, including a detailed history, full physical examination, complete blood count, ESR, blood sugar, electrolytes, (ECG) electrocardiogram, and Echocardiography. EEG had done only for patients with positive family history of seizure disorder.?Holter ECG done for pts with significant cardiac signs, and stress ECG done only for 2 pts. Patients with sickle cell anemia, CNS diseases, trauma associated chest pain, and syndromic pts, with chest pain are excluded. Statistical analysis was performed using the Odds, Odd-ratio and 95% CI.

Results: 225 patients were seen in this study. 126 pts are male (56%) and 99 female (44%). Electrocardiography (ECG) and Echocardiography were done to all pts. Holter ECG monitoring done in 10 pts (4%). Idiopathic Chest Pain is the most common cause diagnosed in 125 patients (56%), it is more common in elder pts >10 yr and it is a diagnosis of exclusion. Musculoskeletal causes account for (16 %. Pulmonary causes account for 13%. Cardiac causes, account for 15 pts. (7%), Gastrointestinal causes account for 4%. Psychological causes account for 10 pts (4%), school and family related problems are the most common psychological problems..

Conclusion: Idiopathic chest pain is the most common in children and slightly more common in males. Cardiac causes are rare. Detailed history, full clinical examination, CXR, and ECG can diagnose the majority causes. Echocardiography, Holter ECG, and EEG reserved for some cases when associated with significant cardiac or neurological symptoms and signs.