Chest pain (peds)

DDx

1. Idiopathic-most common
   1. Precordial catch: pain w/ deep inspiration, self-resolving
2. Musculoskeletal (costochondritis, trauma)
3. Pulmonary-10%
4. GI (e.g. esophagitis)
5. Psychosomatic
6. Cardiac-1%
   1. L-sided obstructive lesions
   2. Arrhythmias
   3. IHSS
   4. Pericarditis
   5. Prinzmetal's angina (vasospasm)
   6. MI (rare, even post-Kawasaki)
   7. Mitral valve prolapse

Work-Up

1. Careful physical exam
   1. Listen for murmurs
   2. Palpate
   3. Compress rib cage
2. EKG
3. CXR
4. Consider echo

Source

Adapted from Pani