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Clinical Reference Systems: Pediatric Advisor 10.0
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Chest Pain

DESCRIPTION

Your child complains of pain in the chest (front or back). Most acute chest pain is associated with a hacking cough. Coughing can cause sore muscles in the chest wall, upper abdomen, or diaphragm. Occasionally a child has chest pain after strenuous exercise, lifting, or work that involves the upper body. This type of muscle soreness often increases with movement of the shoulders. Heart disease is hardly ever the cause of chest pain in children.

The most common cause of recurrent chest pains in adolescents and adults is the precordial catch syndrome. This pain occurs just below the left nipple and comes on suddenly. The pain feels sharp or knifelike, causing the person to not want to move. Usually within 1 minute, the pain is gone. The cause is not known for sure, but it may result from a pinched nerve. Although these pains may recur for years, the precordial catch syndrome is completely harmless. Daily stretching exercises sometimes reduce these sudden sharp pains.

HOME CARE

Treat sore, strained chest muscles with acetaminophen or ibuprofen four times a day. Continue this until 24 hours have passed without pain. You can also relieve muscle spasms by putting a heating pad or warm washcloth on the area for 20 minutes. Your child will probably stop having these muscle pains within 7 days.

If the pain is caused by coughing, give your child a cough-suppressant medicine containing dextromethorphan (DM).

(See Cough .)

CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:

  • The pain is severe AND lasts more than 1 hour.
  • Your child is having difficulty breathing or is breathing fast.
  • Your child is acting very sick.

CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:

  • The chest pain is caused by coughing or pulled muscles AND it persists more than 7 days.
  • Chest pains are a recurrent problem for your child.
  • You have other concerns or questions.

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright 1999 Clinical Reference Systems