Chest pain (peds)
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Background
Clinical Features
Differential Diagnosis
- Idiopathic (most common)
- Precordial catch syndrome
- Sudden, intense pain with deep inspiration, self-resolving
- Musculoskeletal
- Costochondritis, trauma
- Pulmonary
- GI
- Psychosomatic
- Cardiac (1%)
- Left-sided obstructive lesions
- Dysrhythmias
- HOCM
- Pericarditis
- Prinzmetal's angina (vasospasm)
- MI
- Rare, even post-Kawasaki
- Mitral valve prolapse
Diagnosis
- Physical exam
- Listen for murmurs
- Palpate
- Compress rib cage
- ECG
- CXR
- Consider echo