Chest pain in a teenager. Why does a teenage girl have chest pain? What is "masked hypertension"

Pain and its causes in alphabetical order:

chest pain in children

Chest pain in children– an unusual phenomenon in the general pediatric population, but quite common reason to contact a pediatric cardiologist and seek emergency care, due to the fact that chest pain is often associated with atherosclerotic heart disease and heart attack in adults.

Pain when breathing in young children is recognized by external manifestations. Older children themselves report it, although to an insufficient extent. Sensory innervation of the chest is provided by segmental intercostal nerves. Almost half of all sensory fibers approach the diaphragm as part of the phrenic nerve. Pain sensitivity of all organs in the chest cavity is ensured only sympathetic nerves. Therefore, pain in the chest wall is perceived as superficial, accurately described, localized and delimited. Visceral pain due to damage to the organs of the chest cavity, on the contrary, often radiates, is dull, diffuse and is perceived as coming from the depths.

Pain in the chest wall can be classified as follows: constant pain; pain independent of breathing; pain that occurs only when breathing; constant pain that gets worse with breathing. Pain during movements not related to breathing is caused by damage to the vertebrae, ribs and muscles. If similar pain occurs when breathing, during coughing, sneezing or laughing, then in addition to this pathology, one should think about damage to the pleura. Children describe their pain sensations incompletely and inaccurately, so objective research methods and their sequential implementation are crucial for them: thorough examination, palpation, percussion, auscultation, X-ray examination, general blood test, tuberculin diagnostics.

What diseases cause chest pain in children:

Chest pain in children may indicate the presence of dangerous diseases.

Most children have complained of chest pain at some time. It is necessary to find out the exact location of the pain, since the child often calls the chest the pit of the abdomen. The following details are important: how movements affect the nature of the pain, whether they occur during muscle tension after eating, whether they appear during physical work or during sleep, whether the child suffers from bronchial asthma.

1. Sudden sharp stabbing chest pain: This condition is characterized by cramping pain in the lower chest, usually on one side, or in the upper abdomen. Typically occurs after eating during physical stress. The cause of this pain is tension in the ligaments of the peritoneum (the membrane covering the abdominal cavity), which are connected to the diaphragm.
Help: calm the child down, let him rest. After some time, the pain should subside spontaneously.

2. Psychogenic pain in the chest: if one of the adult family members constantly complains of chest pain, then the child may begin to imitate them. This kind of pain does not occur when the child is sleeping or playing. Stress and anxiety can cause pain anywhere, including in the chest. In this case, the diseased area has blurred boundaries, and the child cannot accurately determine the area of pain.
Help: try to distract the child by talking or playing.

3. Pain during skin diseases: Chest pain can occur with shingles. In this case, you may notice a rash on the skin in the form of grouped red bumps or blisters. In addition, there is an increase in body temperature and enlargement of the lymph nodes.
Help: since shingles is an infectious disease, it is better to call a doctor at home and not take the child to the clinic, where he can infect other children.

4. Pain of muscle origin: a common cause of complaints of chest pain in children is bruises or viral myalgia (muscle inflammation caused by a viral infection). Pain usually occurs unexpectedly and has a clear localization. The muscles in the affected area are painful to the touch. Other painful symptoms are missing.
Help: applying heat (heating pad, woolen cloth) to the sore spot helps. At severe pain You can give a crushed tablet of aspirin or panadol. Doses are prescribed by the doctor after examination.

5. Pain due to damage to the spine: disease cartilage tissue ribs (costochondritis), damage to the vertebral processes due to injury, tuberculosis or rheumatoid arthritis leads to pinched nerves and chest pain.
Help: to eliminate the cause of pain, it is necessary to treat the underlying disease.

6. Pain due to lung diseases: It is reasonable to think about this cause of pain especially when other symptoms of pneumonia are present - cough and fever. If your child has pain similar to pleural pain, consult a doctor immediately.
Help: inflammation of the pleura of an infectious nature is more common in severe forms of pneumonia. The child needs urgent hospitalization.

7. Pain in cardiovascular diseases: with rheumatism, tuberculosis, after acute respiratory infections, pericarditis (inflammation of the membrane covering the heart) or myocarditis (inflammation of muscle tissue hearts). The pain is usually dull, aching without clear localization, and can radiate to the shoulder or neck. It intensifies with swallowing and vigorous exercise. breathing movements. In this case, murmurs are heard in the heart, synchronous with heartbeats.
Help: The child should definitely consult a doctor. If the diagnosis is confirmed, hospitalization is necessary.

8. Pain due to damage to the esophagus: pain in the sternum area can be caused by inflammation of the esophagus (esophagitis) if the child has swallowed a substance that irritates the mucous membrane. Other causes of pain include a foreign body in the esophagus (eg, fish bone), hiatal hernia, esophageal ulcer. The pain intensifies when swallowing, lying down or bending forward. In addition, the child may have difficulty swallowing, vomit blood, have black stools, or produce excess saliva.
Help: the child needs an endoscopic examination of the esophagus, which can only be done in a clinic or hospital. If symptoms are severe, e.g. sharp pains if swallowing, bloody vomiting, you must call an ambulance.

9. Sometimes physical exercise can cause harmless, although intense pain in the baby's chest, occurring in the lower part, usually on the front side. It goes away after a few minutes of rest from physical activity.
The cause of this pain is unclear; Perhaps the pain is due to tension in the ligaments that attach the diaphragm - a group of muscles that separate the chest from abdominal cavity, - to the ribs.

10. Chest pain that worsens with movement is most likely traumatic in nature, even if there are no external signs of injury. Usually the bruised area becomes painful sensitivity. As in the case of pleural pain, this pain intensifies slightly with a deep breath or cough, but it reacts much more strongly to movements of the body and limbs. In contrast to pleural pain, the pain intensifies when pressing on the site of pain.
Pain localized to one area of the chest that becomes tender is likely to indicate a rib fracture, especially if it occurs after a serious injury. Suspicion of a rib fracture is confirmed if pressing on the sternum from the front causes pain in the previously developed area of pain in the projection of the rib.
Broken ribs heal on their own in a few weeks without any treatment. However, if you think your child has a broken rib, see your doctor to confirm the diagnosis and make sure there is no damage to the lungs.

11. Acute pain behind the sternum during a cold or sore throat may indicate tracheitis - inflammation of the trachea. Tracheitis is caused by the same microbes as sore throat. A common symptom In addition to pain, the disease also includes a dry cough. Tracheitis goes away in a few days. Paracetamol can be used to relieve pain.

12. The development of breasts in girls and boys during adolescence can cause swollen glands and, as a result, chest pain. However, they are short-lived and usually last no more than two months.

13. Inflammation of breast tissue. This condition in adolescents is known as costochondritis (inflammation or infection at the junction of the ribs and the sternum).

Be sure to consult your doctor if:
- Chest pain is accompanied by other symptoms: frequent cough, slight fever.
- Pain caused by a minor blow or injury to the chest persists, but not in an intense form, for more than one day. In such a situation, the pain, although constant, should not interfere with the child's normal activities.
- There are frequent moderate chest pains.

You should tell your doctor immediately if:
- Chest pain is severe and constant. The pain is accompanied high temperature, above 38.5° C.
- The child cannot take a deep breath because of the pain.
- The child cannot lead a normal life, the child breathes quickly, he does not have enough air, the temperature is elevated.
- The child has been hit in the chest or injured, but can walk and move despite severe pain.

Which doctors should you contact if chest pain occurs in children:

Do you experience chest pain in children? Do you want to know more detailed information or do you need an inspection? You can make an appointment with a doctor Eurolab always at your service! The best doctors they will examine you and study you external signs and will help you identify the disease by symptoms, advise you and provide necessary help. you also can call a doctor at home. Clinic Eurolab open for you around the clock.

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If you have previously performed any research, Be sure to take their results to a doctor for consultation. If the studies have not been performed, we will do everything necessary in our clinic or with our colleagues in other clinics.

Do your children have chest pain? It is necessary to take a very careful approach to your overall health. People don't pay enough attention symptoms of diseases and do not realize that these diseases can be life-threatening. There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that, unfortunately, it is too late to treat them. Each disease has its own specific signs, characteristic external manifestations - the so-called symptoms of the disease. Identifying symptoms is the first step in diagnosing diseases in general. To do this, you just need to do it several times a year. be examined by a doctor to not only prevent terrible disease, but also support healthy mind in the body and the organism as a whole.

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The symptom chart is for educational purposes only. Do not self-medicate; For all questions regarding the definition of the disease and methods of its treatment, consult your doctor. EUROLAB is not responsible for the consequences caused by the use of information posted on the portal.

If you are interested in any other symptoms of diseases and types of pain, or you have any other questions or suggestions, write to us, we will definitely try to help you.

As a teenage girl, you are likely to experience pain in the chest area. Your breasts hurt due to changes happening in your body and increased release of hormones. You can relieve chest pain in several ways. This involves making some changes in your life (small ones) and accepting medical supplies. You should also learn to distinguish chest pain caused by puberty from other causes.

Steps

Lifestyle change

Wear a supportive bra. Once you go through puberty, your breasts will become heavier. Without wearing a bra, if you have large breasts, you may experience pain as your body has not yet adjusted to carrying the extra weight. A supportive bra will take this weight and help control pain.

Go to a lingerie store and pick out a model that fits in size and is comfortable.

Do exercises to reduce pain. The inner parts of the chest muscles, called the pectoral muscles, should be developed to help you cope with the weight of your growing breasts. Perform an exercise for the pectoral muscles:
- Bend your elbows at right angles and raise them to chest level. Lower to the sides, then lift again to chest level.
- Perform the exercise 20 times in the morning and evening.
Eat fruits and vegetables. Citrus fruits and vegetables contain lycopene and antioxidants. They help prevent the formation of free radicals in the body, causing pain in the chest. Citrus fruits also strengthen the immune system and improve overall health.
- Good choices include oranges, melons, tomatoes, spinach and papaya.
Reduce the amount of caffeine you consume. Caffeine contains methylxanthines, which cause pain. They stimulate the production of cyclooxygenase enzymes, a mechanism that accelerates pain awareness in the body and thus increases pain sensations. Excessive caffeine consumption can also disrupt your sleep, making your pain even worse. Products containing caffeine include:
- Coffee and black tea
- Most carbonated drinks
- Energetic drinks
- Chocolate
Limit your salt intake. Salt causes fluid retention in the body and bloating, which results in breast swelling. All this can lead to increased sensitivity. Reduce your salt intake and provide your body with enough water.

Use oils containing vitamin E. Vitamin E is fat soluble, which allows it to function as an antioxidant. Antioxidants protect your body's tissues, including breast tissue, from damage caused by free radicals. Vitamin E will also help relieve inflammation that leads to breast tenderness and pain.

Taking medications

Learn to recognize serious causes
1. Learn to differentiate between breast pain symptoms caused by puberty and the menstrual cycle. Chest pain that begins in adolescence signals the onset of puberty. This means that your breasts are growing and the onset is approaching. menstrual cycle. During these periods, it is quite normal to experience pain in the chest area. General symptoms include:
  - Breast tenderness, especially in the nipple area. This can be caused by hormonal changes, wearing a bra that is too tight, or putting it on before bed.
  - Feeling of excessive heaviness in the chest. During the growth of fat cells and their vessels, the volume of breast tissue also increases.
  - Feeling of warmth in the chest. This is due to the occurrence of multiple reactions to cellular level, during which hormones act on cells and glands.
  - See your doctor if you have very severe or recurring pain that interferes with your ability to normal image life.
2. Have your breasts examined regularly by your doctor. Doctors usually do not carry out comprehensive survey mammary glands in adolescents. However, you should make it a habit to feel it yourself regularly, especially if you constantly experience chest pain. This way you can get an answer to all your suspicions if you really have a problem.
  
  Contact your doctor if you notice a lump inside your breast. Sometimes you may feel lumps in your breasts due to high content estrogen during menstruation. During puberty, you may also notice harmless bumps(such as breast buds) that are part of the normal development of your breasts. Visit your doctor for an examination if you notice hard, immobile lumps that bother you.

Adults often associate chest pain in a child with heart ailments. But in reality this is far from the case. Studies conducted in the United States have shown that in adolescents and young children, chest pain is not associated with heart disease in 99% of cases. Like this. This study involved no less than 3,700 children from Boston with heart pain, patients at Boston Hospital, and only 1% of them were diagnosed with cardiovascular disease. What are the causes of chest pain in children and what can be done about it?

Causes of chest pain in children

The study we wrote about above involved children average age who was barely 14 years old. 99% of them were diagnosed with diseases of the bone tissue, musculoskeletal system, digestive system, central nervous system. Some children experienced chest pain due to uncontrolled use of medications that caused allergies. And only 1% of children experienced chest pain due to cardiovascular problems. Therefore, doctors strongly advise parents who find chest pain in their children to first do an ECG.

This will immediately eliminate the risk of cardiovascular disease or confirm heart problems. And then you need to navigate according to the picture of the disease. This will make it possible not to waste time on taking medications for cardiovascular diseases, if there is no trace of them. This time will be useful to identify real reason chest pain in children.

So, the causes of chest pain in children can be:

Psychogenic pain
Pain due to damage or skin diseases
Pain due to muscle dysfunction
Pain due to diseases of the respiratory system
Pain due to cardiovascular diseases
Pain due to lesions gastrointestinal tract

First you need to ask the child in detail where exactly the pain occurs, because young children very often indicate different places that hurt. Therefore, pain in the pit of the stomach, indicating diseases of the digestive system, can easily be confused with pain in the chest - the child may call both parts of the body the chest. Also ask your child about the nature of the pain that bothers him. Are they sharp, piercing or dull, pulling? When does a child experience chest pain? After eating, while moving, after active sports? Let's look at each of the causes of chest pain in a child in more detail.

Pain due to diseases or damage to the skin

Pain due to diseases or damage to the skin can bother a child if he has herpes or shingles. This disease tends to affect the skin with rashes, sores or blisters. And then the child complains of burning pain in the chest. They may be accompanied by fever or lymph nodes that are significantly enlarged.

How to help?

Shingles, or herpes, is viral disease, which, moreover, is infectious, that is, it is transmitted from child to child. To cure it, you need to call your local doctor and follow the treatment regimen that he prescribes.

Chest pain in a child due to musculoskeletal diseases

Chest pain in a child due to diseases of the musculoskeletal system can be quite severe and acute. Sources of pain can be changes in the vertebral processes after injury, pain due to damage to cartilage in the spine, rheumatoid arthritis, tuberculosis. All these diseases lead to pinched nerve roots, and this is very painful.

How to help?

It is necessary to take the child to a rheumatologist for diagnosis and treatment.

Chest pain in a child due to diseases of the respiratory system

Chest pain in a child can most often occur due to damage or inflammation of the lungs. This respiratory organ is surrounded by the pleura, a membrane that lines chest cavity. When the pleura is inflamed, its leaves (it consists of sheets, very thin) rub against each other, and this causes severe pain in the baby's chest. They are very difficult to endure, the pain intensifies even more during deep breathing and can radiate to the shoulder joint.

How to help?

A child may experience such pain when pneumonia has worsened, the lungs are in in serious condition, they are inflamed and affected by the virus. In this condition, self-medication is unacceptable. You need to immediately call a doctor and treat the child in a hospital, usually with antibiotics.

Chest pain in a child due to cardiovascular diseases

Cardiovascular chest pain in a child is one of the most dangerous species pain. They can occur when various diseases heart and blood vessels, in particular, rheumatism, ARVI (acute respiratory infections), which cause inflammation of the lining of the heart - the pericardium or inflamed muscles of the heart (a disease called myocarditis). Cardiovascular diseases not associated with myocardial infarction or angina pectoris can be recognized by dull and nagging pain, such pain can radiate (spread) to the neck or shoulder.

If there is any doubt about what disease is causing the pain, you should definitely listen to the child with a stethoscope. And then the doctor can hear extraneous noises in the area of the heart that “keep pace” with each heartbeat, that is, synchronously. A child's chest pain due to heart disease may also become worse when swallowing or deep breathing.

How to help?

If the heart and blood vessels are not normal, this is a great danger for the child. You should consult your doctor immediately. He will prescribe treatment depending on the nature of the disease.

Chest pain in a child due to diseases of the digestive system

Chest pain in a child due to diseases of the gastrointestinal tract can be very severe and indicate serious health problems. There may be congestion in digestive tract, gas reflux disease (heartburn), inflammation of the esophagus, which doctors call esophagitis, as well as poisoning with substances that can irritate the delicate mucous membrane of the esophagus or stomach.

Diseases of the digestive system that cause chest pain in a child may be a stomach ulcer or duodenum, hiatal hernia, foreign body that the child swallowed (for example, a bone). Such pains can be recognized by their nature: they become stronger when swallowing, in a lying position or when the child leans forward. Accompanying symptoms are difficulty swallowing, vomiting blood, stool with black discharge, and increased salivation.

How to help?

You need to immediately call an ambulance and take the child to the hospital. First of all, he needs to have an esophageal endoscopy (examination of the esophagus using computer diagnostics and an instrument called an endoscope). Next, the doctor will prescribe treatment depending on what diseases the child suffers from.

Psychogenic chest pain

Psychogenic chest pain can begin if the child is not sick, but is experiencing a state of acute stress. Then there appear in the chest muscle clamps, and the child complains of chest pain. The child may also worry about the condition of a person close to him, for example, his mother, and imitate chest pains that she suffers from. Psychogenic pain can be determined by the time when it occurs. As a rule, these pains bother the child only when he is awake, and in a state of sleep or while the child is engrossed in a game or an interesting book, the pain goes away.

How to help?

It is necessary to give the child the opportunity to rest more, play, be on fresh air. If chest pain does not go away, you need to show the child to a neurologist and psychologist.

Sudden severe stabbing pain of unknown etiology

Sudden severe stabbing pain unknown etiology may occur in a child, most often after eating or with strong physical stress. This pain may be accompanied by contractions in the chest area (attacks of pain), localized in the upper abdomen or lower chest. As a rule, such pain is more often localized on the right. This pain may be caused by strained ligaments between the abdominal lining (peritoneum) and the diaphragm.

How to help?

Pain of this nature in a child should go away after he has rested and calmed down. The child should lie down, the peritoneal ligaments will relax and then all the pain will go away. Even without drugs.

Baby's chest pain due to muscle tension or muscle damage

Chest pain due to muscle problems can occur after injuries, muscle strains, bruises, and also due to viral infections in the muscles. The latter disease leads to muscle inflammation, which is called viral myalgia. It is characterized by the fact that the child’s muscles in the chest area become very painful, and this pain comes unexpectedly, it is strong, and can be felt even with light pressure with your fingers. As a rule, this is the only area of pain; there are no other abnormalities in the child’s condition.

How to help?

For bruises and sprains, you need to alternate heat and ice (15 minutes each). Warm compresses Can be salt heated in a frying pan or a warm heating pad. You can also heat a woolen scarf over warm battery and apply it to the baby's sore breast.

If your chest hurts a lot, you can give it an anti-inflammatory and pain reliever, such as ibuprofen. You can also give your child Panadol - it relieves pain and inflammation well.

How to determine diseases by the nature of chest pain in a child?

If the pain gets worse with movement, it is most likely caused by an injury or muscle strain. It could also be a muscle strain or inflammation. Parents should pay attention to these symptoms even if there are no bruises or other signs of injury on the child's chest. Additional symptom– pain with light touch, breathing, coughing.

If your child's chest pain is concentrated in only one place that constantly hurts, it may be the result of a rib fracture. Additional symptoms are sharp pain when moving or touching, and this pain is in the area where the ribs are located. This kind of pain doesn't go anywhere anymore.

Severe and sharp pain in the child’s chest, as if behind the sternum, from behind - this is a symptom of a sore throat or colds. Such pain can be caused by a disease of the trachea, in particular, its inflammation. The microorganisms that cause sore throat and tracheitis are the same. An additional symptom of this disease is a dry cough, pain that increases with deep breathing.

Pain in a child's chest in the form of a burning sensation that occurs after eating is a sign of a disease of the digestive system, in particular the stomach. This pain is caused by acid that rises from the stomach back into the esophagus. There are children who especially often suffer from heartburn and increased acidity. To avoid this condition, you do not need to overeat and bend over after eating, but sit straight. If these simple remedies do not work, you need to take your child to the doctor.

It would seem that such a symptom is more typical for adult patients, but children often present similar complaints. And first of all, you need to figure out what they are connected with and what the origin of the pain is.

Causes and mechanisms

Unlike adults, whose chest pain is most often associated with diseases of the heart and blood vessels, in children the source of the problem, as a rule, lies in a different plane. The spectrum of pathology may include diseases various organs and many of them are quite serious. These include problems with the following systems:

Osteochondral (Tietze syndrome, scoliosis and other spinal diseases).
Muscles and skin (bruises, myalgia, herpes zoster).
Respiratory (tracheitis, pneumonia, pleurisy, pneumothorax, tuberculosis).
Digestive (esophagitis, diaphragmatic hernia, achalasia cardia).
Cardiovascular (neurocirculatory dystonia, pericarditis, myocarditis).

At the same time, there are other causes of pain in the chest area in a child. For example, a similar syndrome can occur after excessive physical activity as a result of tension in the abdominal or back muscles. There are also transient (transient) conditions associated with the development of the mammary glands and hormonal changes in girls during puberty. But they are not long-lasting and pass without a trace.

It is also necessary to exclude the psychogenic origin of pain, when it has no physical basis, but develops during stressful situations or as a simulation reaction. Based on the variety of causes, this symptom is subject to careful differential diagnosis identifying the source of the problem and likely risks. But only a specialist can do this, so you should not delay contacting a doctor.

The causes of chest pain in a child can be various conditions that require high-quality and timely medical diagnosis.

Symptoms

Determining the origin of the pain syndrome begins with clinical examination. At the initial stage, the doctor finds out what is bothering the child and details his complaints. It is necessary, if possible, to identify all the features of pain:

Character: sharp (cutting, shooting, pulsating) or dull (aching, pressing, pulling).
Localization: in the middle, on the side, in the top or lower parts, from the back.
Intensity: moderate, strong or weak.
Duration: short or long.
Connection with certain factors: physical activity, movements, breathing, nutrition, stressful situations.

Any item may have important for diagnosis, therefore, a detailed assessment of subjective data is necessary, taking into account the time of onset of symptoms and their further development. After the interview, the doctor conducts an examination and physical examination (palpation, percussion, auscultation). This allows us to identify objective signs of damage, which are different for each disease. This is how a preliminary diagnosis is formed.

Osteochondral system

Diseases of the musculoskeletal system often manifest as chest pain. A very common cause of such manifestations in a child is Tietze syndrome (chondropathy). It is characterized by aseptic inflammation of the cartilage of the upper ribs (I–IV) at the site of their attachment to the sternum. Its appearance is associated with injury, respiratory infections, allergies or metabolic disorders. As a rule, the process is one-sided and is manifested by acute pain in the upper chest, which gradually increases. It gets worse with movement, coughing, sneezing or breathing, and can radiate to the arm on the affected side. As a rule, the disease has a long course with alternating periods of exacerbation and remission. Upon palpation in the area of cartilage, painful swelling in the form of spindle-shaped thickenings is determined.

With severe scoliosis or other problems with the spine (disc herniation, trauma, bone tuberculosis), chest pain also appears. But their origin is different. This is called radicular syndrome, which occurs when the nerves coming from the spinal cord in the area are compressed or irritated. thoracic spinal column. The pain will be shooting or stabbing, with a feeling of numbness and burning along the intercostal spaces. Deformations from the back are detected: curvature along the axes, protrusion of one or more spinous processes. The paravertebral points are painful, and the longitudinal muscles are tense. Movements in the spine are difficult and are accompanied by increasing pain.

Muscles and skin

Chest pain occurs due to soft tissue injuries. Most often we are talking about injuries - bruises or sprains. In this case, the history will indicate the impact of a mechanical factor, and examination and palpation will reveal swelling, bruising and bruising. Unpleasant sensations intensify with any movements affecting the chest.

Muscle tissue and skin can also be affected by infectious pathology. For example, a local inflammatory process like epidemic myalgia is associated with infection with the Coxsackie virus group B. The infection begins acutely with a fever that can reach 39 degrees and above. Sharp, paroxysmal pain in the chest occurs that is not associated with external factors. Other signs that are typical for children include:

Headache.
Increased breathing.
Sweating.
Redness of the nasopharyngeal mucosa.
Enlarged lymph nodes.
Skin rashes.

Other muscle groups are also affected - limbs, back and abdomen - which is accompanied by corresponding symptoms. I am worried about body aches and malaise as a result of intoxication. Entero viral infection may give other manifestations, for example, in the form serous meningitis, diarrhea or sore throat.

Herpes virus type 3 can cause another disease - herpes zoster. The infection is characterized by damage to nerve fibers (most often intercostal). First, quite intense pain, itching and burning, and then redness and small blisters appear here. The elements of the rash are filled with transparent contents and are prone to merging. After the tire bursts, eroded surfaces with polycyclic outlines are formed. Herpes zoster is mostly unilateral. Acute process lasts a couple of weeks, after which skin manifestations disappear, but the virus continues to persist in the body, located in the nerve ganglia, and under favorable conditions (for example, hypothermia) is reactivated.

Damage to the skin and muscles of a traumatic and infectious nature is a fairly common cause of chest pain in pediatric patients.

Respiratory system

If a child has chest pain, then it is worth thinking about diseases of the respiratory system. First of all, we are talking about inflammatory pathology. Respiratory infections, bronchopneumonia, pleurisy and tuberculosis are the list of the main causes of pain. Unpleasant sensations are associated with breathing and are accompanied by other symptoms:

Cough (dry or with phlegm).
Lack of air (shortness of breath).
Increasing temperature.
Malaise and fatigue.

With ARVI, catarrhal symptoms are observed in the form of a runny nose and sore throat, pleurisy is characterized by a weakening of pain when lying down on the affected side, and tuberculosis occurs over a long period of time with sweating, low-grade fever and emaciation. Physical data are also of great importance: hard or weakened breathing, wheezing (dry or wet), dullness of percussion sound.

In addition to inflammatory diseases, there are also acute pathology of a different origin. If the lung tissue with the parietal pleura is damaged, pneumothorax occurs. This condition is caused by the accumulation of air in the pleural cavity. The disease is characterized by increasing shortness of breath, sharp chest pain, pallor or cyanosis of the facial skin, and a feeling of fear. Breathing becomes frequent and shallow. During percussion, a sound with a boxy tint is detected.

Digestive tract

Chest pain that appears in a child may also indicate diseases of the digestive system. It's about about damage to the upper sections: the esophagus and gastric cardia. Common signs for esophagitis, diaphragmatic hernia and achalasia can be considered:

The inflammatory process in the mucous membrane of the esophagus can occur with erosions and even ulcers. Damage also occurs upon contact with aggressive chemical media or foreign bodies (for example, stuck fish bone). In severe cases, bleeding occurs from top floor digestive tract, which is accompanied by vomiting and black feces (melena). With achalasia cardia, there is an increase in the tone of the lower esophageal sphincter, which provokes regurgitation after eating, rotten belching, and emaciation. A hernia is characterized by protrusion upper section stomach through an enlarged opening in the diaphragm.

Chest pain can also be felt by children with gastritis, ulcer-like dyspepsia, cholecystitis or pancreatitis. Damage to the abdominal organs is accompanied by irradiation of unpleasant sensations upward according to the Zakharyin-Ged zones (visceral-cutaneous reflexes). Therefore, the child feels pain below the sternum or in the hypochondrium.

Pathology of the digestive system constitutes a wide range of conditions that can be accompanied by pain in the chest area.

Heart and blood vessels

As stated earlier, pathology of the cardiovascular system rarely causes chest pain in a child. Per share similar cases accounts for no more than 1%. But to exclude dangerous conditions, you should always be aware of this possibility. Organic heart damage most often occurs as peri- or myocarditis. They are caused by infectious processes of a viral, bacterial or allergic nature (ARVI, rheumatism). Dull pain is felt in the precordial area, they are not associated with breathing or movement and are almost constant. Other symptoms are also typical:

Increased heart rate.
Dyspnea.
Pale or bluish skin.
Temperature increase.

Cardiac auscultation reveals pathological noises(valvular and pericardial), and percussion gives an idea of the expansion of the physiological boundaries of the organ. But in addition to organic pathology, pain can be of a functional nature - with neurocirculatory dystonia of the cardiac or mixed type. The child also complains of dizziness, sweating, anxiety, bad dream. When measuring blood pressure, it is often reduced.

Additional diagnostics

Given the fairly wide range of pathologies that are accompanied by chest pain, a thorough examination of the child for any of the diseases discussed is necessary. List diagnostic measures determined based on a preliminary medical opinion and may include the following laboratory and instrumental procedures:

General blood and urine tests.
Blood biochemistry (acute phase indicators, rheumatic tests, antibodies to infections, oxygenation, electrolytes, etc.).
Sputum examination (microscopy, culture, PCR).
Tuberculin tests.
X-ray of the chest and spine.
Ultrasound of the heart and abdominal cavity.
Electrocardiogram.
Fibrogastroscopy.
Tomography.

The final diagnosis is made only based on the results of a comprehensive examination. You will probably have to involve related specialists: a gastroenterologist, an infectious disease specialist, a cardiologist, a vertebrologist or a neurologist. And having installed the only the right reason pain in the chest, you should begin to eliminate the pathology. The doctor will tell you what treatment is indicated for the child. And it is important for parents to fully follow his recommendations.

Chest pain in a child, causes, symptoms, treatment

Pain in the chest area is observed much less frequently than headache or abdominal pain.

It occurs with herpes, rib fractures, pericarditis and other diseases.

Children describe their pain sensations incompletely and inaccurately. Objective examination methods play a decisive role: inspection, percussion, palpation, auscultation, x-ray examination, blood test.

Herpes zoster (shingles) is a disease caused by the chickenpox virus.

Clinical picture. The concern is a sharp girdle pain, accompanied by the appearance of blistering rashes, usually one-sided, on the skin of the chest along the intercostal nerves. Regional lymphadenopathy is observed. Most of the bubbles subsequently dry out with the formation of crusts, some open and erosions form in their place.

Treatment. Paracetamol is prescribed - pomg/kg body weight 3 times every day, diclofenac sodium - 2-3 mg/(kg-day), B vitamins, acyclovir - 20 mg/(kg-day) orally. Locally - treatment with solutions of aniline dyes (methylene blue, brilliant green), the use of ointments with antiviral properties (tebrofen, oxolin, etc.), lotions with interferon.

A rib fracture usually occurs due to direct mechanical force or a fall. Fractures can be open or closed, single or multiple.

Clinical picture. Complaints of pain in the chest area. There is a connection with trauma; local pain in the rib area, limited swelling, sharp pain on palpation. The diagnosis is confirmed by X-ray examination.

Treatment. Analgesics are prescribed: paracetamol - pomg/kg 3 times every day, diclofenac - 2-3 mg/(kg/day). A consultation with a surgeon is indicated.

Pericarditis is an inflammation of the heart lining of an infectious, allergic, immunocomplex or other origin (for example, with diffuse diseases connective tissue, uremia, hemorrhagic diseases, tumors). The accumulation of a large volume of fluid in the pericardium leads to cardiac tamponade due to difficulty in its diastolic expansion. In this case, the pain has a different character.

Clinical picture. With effusion pericarditis, pressing pain is accompanied by a forced position of the body, swelling of the neck veins, expansion of the borders of the heart, dullness of tones, a triangular shadow of the heart on an x-ray, and low voltage waves on an ECG. Dry pericarditis causes stabbing pain that worsens with deep breathing and changes in body position.

Treatment. NSAIDs are prescribed: indomethacin - 2-3 mg/(kg-day), diclofenac - 2-3 mg/(kg-day), ibuprofen - pomg/(kg-day). Treatment of the underlying disease.

Damage to the parietal pleura is accompanied by pain in the chest wall.

Clinical picture. Sharp, stabbing pain when breathing (increases with deep inspiration, coughing). Breathing is often shallow, gentle, cough is short, obsessive, dry.

Treatment. Paracetamol is prescribed - pomg/kg 3 times every day, codeine - for children over 6 months, 0.002-0.01 g. Treatment of the underlying disease.

Chest pain in children

General information

This study included more than 3,700 children from Boston with heart pain, patients at Boston Hospital, and only 1% of them were diagnosed with cardiovascular disease. What are the real causes of chest pain in children and what can be done about it?

Causes of chest pain in children

The study we wrote about above involved children whose average age reached 14 years. 99% of them were diagnosed with bone tissue diseases, as well as diseases:

central nervous system (CNS).

Some children experienced chest pain due to uncontrolled use of medications that caused allergies. And only 1% of children experienced chest pain due to cardiovascular problems. Therefore, doctors strongly advise parents who find chest pain in their children to first do an ECG.

This will immediately eliminate the risk of cardiovascular disease or confirm heart problems. And then you need to navigate according to the picture of the disease. This will make it possible not to waste time on taking medications for cardiovascular diseases. This time will be useful to identify the real cause of chest pain in children. So, true reasons Chest pain in children can be:

skin damage or disease;

pain due to muscle dysfunction;

respiratory system disorders;

lesions of the gastrointestinal tract.

First, you need to ask the child in detail where exactly the pain occurs, because young children very often indicate different places. Therefore, pain in the pit of the stomach, indicating diseases of the digestive system, can easily be confused with pain in the chest - the child may call both parts of the body the chest. Also ask your child about the nature of the pain that bothers him. Let's look at each of the causes of chest pain in a child in more detail.

Pain due to skin diseases

Shingles, or herpes, is a viral disease, which is also infectious, that is, it is transmitted from child to child. To cure it, you need to call your local doctor and follow the treatment regimen that he prescribes.

Diseases of the musculoskeletal system

Respiratory system diseases

Chest pain in a child can most often occur due to damage or inflammation of the lungs. This respiratory organ is surrounded by the pleura, a membrane that lines the chest cavity. When the pleura is inflamed, its leaves (it consists of very thin leaves) rub against each other, and this causes severe chest pain in the child. They are very difficult to endure, the pain intensifies even more during deep breathing and can radiate to the shoulder joint.

A child may experience similar pain when pneumonia has worsened, the lungs are in serious condition, they are inflamed and affected by the virus. In this condition, self-medication is unacceptable. You need to immediately call a doctor and treat the child in a hospital, usually with antibiotics.

Cardiovascular diseases

Cardiovascular pain in a child’s chest is one of the most dangerous types of pain. They can occur with various diseases of the heart and blood vessels, in particular, rheumatism, ARVI (acute respiratory infections), which cause inflammation of the lining of the heart - the pericardium, or inflamed heart muscles (a disease called myocarditis).

Cardiovascular diseases not associated with myocardial infarction or angina pectoris can be recognized by dull and nagging pain; such pain can radiate (spread) to the neck or shoulder. If the heart and blood vessels are not normal, this is a great danger for the child. You should consult your doctor immediately. He will prescribe treatment depending on the nature of the disease.

Digestive system diseases

Chest pain in a child due to diseases of the gastrointestinal tract can be very severe and indicate serious health problems. These may include congestion in the digestive tract, gas reflux disease (heartburn), inflammation of the esophagus, as well as poisoning with substances that can irritate the delicate mucous membrane of the esophagus or stomach.

Diseases of the digestive system that cause chest pain in a child may be a stomach or duodenal ulcer, a hiatus hernia, or a foreign body that the child has swallowed (for example, a bone). Such pains can be recognized by their nature: they become stronger when swallowing, in a lying position or when the child leans forward. Accompanying symptoms are difficulty swallowing, vomiting blood, stool with black discharge, and increased salivation.

You need to immediately call an ambulance and take the child to the hospital. First of all, he needs to have an esophageal endoscopy (examination of the esophagus using a computer scan and an instrument called an endoscope). Next, the doctor will prescribe treatment depending on what diseases the child suffers from.

Psychogenic chest pain

Psychogenic chest pain can begin if the child is not sick, but is experiencing a state of acute stress. Then muscle tension appears in the chest, and the child complains of chest pain. The child may also worry about the condition of a person close to him, for example, his mother, and imitate chest pains that she suffers from. Psychogenic pain can be determined by the time when it occurs. As a rule, these pains bother the child only when he is awake, and in a state of sleep or while the child is engrossed in a game or an interesting book, the pain goes away.

It is necessary to give the child the opportunity to rest more, play, and be in the fresh air. If chest pain does not go away, you need to show the child to a neurologist and psychologist.

Sudden severe stabbing pain of unknown etiology can occur in a child, most often after eating or during severe physical stress. This pain may be accompanied by contractions in the chest area (attacks of pain), localized in the upper abdomen or lower chest. As a rule, such pain is more often localized on the right. This pain may be caused by strained ligaments between the abdominal lining (peritoneum) and the diaphragm.

Pain of this nature in a child should go away after he has rested and calmed down. The child should lie down, the peritoneal ligaments will relax and then all the pain will go away.

For bruises and sprains, you need to alternate heat and ice (15 minutes each). Warm compresses can be salt heated in a frying pan or a warm heating pad. You can also heat a woolen scarf on a warm radiator and apply it to the child’s sore chest.

If your chest hurts a lot, you can give it an anti-inflammatory and pain reliever, such as ibuprofen. You can also give your child Panadol - it relieves pain and inflammation well.

Character of chest pain in a child

If the pain gets worse with movement, it is most likely caused by an injury or muscle strain. It could also be a muscle strain or inflammation. Parents should pay attention to these symptoms even if there are no bruises or other signs of injury on the child's chest. An additional symptom is pain with a light touch, breathing, or coughing.

Severe and sharp pain in the child’s chest, as if behind the breastbone, from behind, is a symptom of a sore throat or a cold. Such pain can be caused by a disease of the trachea, in particular, its inflammation. The microorganisms that cause sore throat and tracheitis are the same. An additional symptom of this disease is a dry cough, pain that increases with deep breathing.

Pain in a child's chest in the form of a burning sensation that occurs after eating is a sign of a disease of the digestive system, in particular the stomach. This pain is caused by acid that rises from the stomach back into the esophagus. There are children who especially often suffer from heartburn and high acidity. To avoid this condition, you do not need to overeat and bend over after eating, but sit straight. If these simple remedies do not work, you need to take your child to the doctor.

Chest pain in a child when coughing is a sign of a disease of the respiratory system, in particular pneumonia. If a child coughs frequently and for a long time, his intercostal muscles may become stretched, causing them to become inflamed and painful. The pain is aggravated by palpation of the chest. These pains will quickly go away as soon as the cough itself goes away.

Whatever the pain in the child’s chest, you should not lose sight of this symptom, because it may be a signal serious illnesses. In order not to be convinced of the presence of these diseases in practice, you need to pay attention to them even in initial stage in order to diagnose and treat in time.

Cardiologist - site about heart and vascular diseases

Heart surgeon online

Chest pain in children

Chest pain is a very common reason why children visit pediatricians, emergency departments, cardiologists and pulmonologists. The media rightly warn people that chest pain in adults is the first symptom of a myocardial infarction and serious illnesses hearts. However, this wariness extends to children, so chest pain is usually perceived by the child and his loved ones as something alarming and dangerous.

The child and his parents usually want to know whether these pains are related to the heart, whether they are dangerous and what consequences they may have. When dealing with chest pain, it is convenient to divide it into acute, severe, persistent pain and chronic, recurring, less severe pain. History taking and physical examination, as well as selection and information content additional methods studies in these situations will differ.

Acute chest pain

These children are usually anxious and seek emergency medical care, during the examination their pain usually remains. A history and physical examination are performed quickly to immediately determine whether the pain is related to the heart or not. When collecting anamnesis, you should pay attention, firstly, to the nature of the pain itself and accompanying complaints, and secondly, to accompanying illnesses which may cause chest pain. It is necessary to find out the time of onset of pain, its duration, nature, strength, localization and irradiation, as well as factors that intensify or alleviate pain. Pay attention to other complaints, such as fever, cough, vomiting, lightheadedness, fainting, palpitations, shortness of breath, sweating. Of the concomitant diseases, special mention should be made of congenital and acquired heart defects, diseases of the lungs and chest, and diseases of the abdominal organs. ECG, echocardiography and chest x-ray are most important when acute pain in the chest.

Cardiac causes of chest pain

Pericardial diseases

Inflammation and irritation of the pericardium (pericarditis) causes severe chest pain, which the patient may describe as squeezing or pressing, so it can sometimes be difficult to distinguish from angina. The pain intensifies with movement, including breathing. The patient tries to find a comfortable position, usually leaning forward and refusing to lie on his back. Pain can be caused by pressing on the sternum. A pericardial friction rub is usually heard. With significant pericardial effusion, the friction noise may be absent, while heart sounds are muffled. It is very important not to miss the signs of tamponade.

Angina and myocardial infarction

This is the most terrible, but at the same time the rarest cause of chest pain in children. The pain is severe, located behind the sternum, patients describe it as burning, pressing or squeezing. It can radiate to the neck and left arm. It usually occurs during physical activity and goes away with rest. Physical examination may not reveal any abnormalities. During myocardial infarction, the ECG shows characteristic changes(elevation of the ST segment and changes in the T wave in the leads corresponding to the affected myocardium and reciprocal depression of the ST segment in the opposite leads). Find out if there is a history hypertrophic cardiomyopathy or Kawasaki disease. In addition, especially if there is no indication of heart disease, you should find out if the child is using drugs, especially cocaine (crack). Cocaine causes spasms coronary arteries due to increased sympathetic tone, which can lead to myocardial ischemia and infarction. In this case, the pain is not associated with physical activity. EchoCG can detect abnormalities of the coronary arteries, their aneurysms (in Kawasaki disease), as well as hypertrophic cardiomyopathy.

Arrhythmias

Tachycardias, especially supraventricular ones, may be accompanied by acute chest pain. Usually children, especially younger age, they simply complain of discomfort in the chest, but with very high heart rate Coronary blood flow may be impaired and ischemia may occur. The pain is usually not associated with physical activity and is often accompanied by lightheadedness, fainting and palpitations. Immediately after the arrhythmia stops, the pain goes away. During an attack, the diagnosis can be made using an ECG. Signs of ischemia on the ECG may remain for some time after the cessation of the arrhythmia.

Aortic dissection

The pain usually begins suddenly and is cutting or tearing in nature. The irradiation of pain depends on the part of the aorta: with dissection of the ascending aorta, the pain is localized in the anterior chest, with dissection of the aortic arch, the pain radiates upward (to the neck), and with dissection of the descending aorta - back (usually to the back). Dysmorphogenetic features of Marfan or Ehlers-Danlos syndrome are usually found. Delamination can begin for no apparent reason or after a seemingly trivial injury. Aortic dissection should be suspected in all patients with severe chest trauma or hemopericardium. Experienced specialist quickly make a diagnosis using transesophageal echocardiography. Emergency surgical treatment is indicated.

Non-cardiac causes of chest pain

Lung diseases

Spontaneous pneumothorax causes severe unilateral chest pain, which the patient often finds difficult to localize. Pain is usually followed by shortness of breath. The diagnosis is indicated by weakening of breathing on one side, as well as displacement of the trachea. Pay attention to bronchial asthma, cystic fibrosis, Marfan syndrome, and a history of trauma. Acute chest pain can be caused by pleurisy, which is characterized by pain on inspiration. Pleurisy most often occurs of viral etiology, in particular with epidemic myalgia, which is characterized by fever and pleural friction noise. At high fever and intoxication, one should think of bacterial pneumonia. In children with sickle cell disease bacterial pneumonia very dangerous and requires emergency treatment. PE is very rare in children, but should be considered when coughing, shortness of breath, or hemoptysis is associated with acute pleuritic pain, especially if there is a history of leg injuries, or in girls taking oral contraceptives.

Diseases of the esophagus and stomach

With gastroesophageal reflux and reflux esophagitis, the pain is usually burning, mild and located behind the sternum, however, sometimes it can be compressive and resemble angina pectoris. The association of pain with eating and its intensification in the supine position indicates reflux esophagitis. Severe chest pain can occur due to a foreign body in the esophagus. Esophageal spasm and rupture of the esophageal lining due to repeated vomiting can cause chest pain, but is rare in children.

When the diaphragm is irritated, the pain usually radiates to the shoulder and bottom part breasts; with fever and normal physical examination of the chest, lungs and heart, a subdiaphragmatic or hepatic abscess should be suspected. With splenic flexure syndrome, splenic infarction and splenomegaly during sequestration crisis, pain may be located in the left shoulder. Pancreatitis causes epigastric pain that can radiate to the back. In addition, pancreatitis may be accompanied by pleural effusion, making the correct diagnosis difficult.

Prolonged and recurring chest pain

These patients often come for a routine appointment with a doctor rather than coming to the emergency department. There is usually no chest pain during examination. Physical examination often shows no abnormalities; anamnesis plays the main role in diagnosis. As with acute chest pain, you should pay attention to the nature of the pain, other complaints and concomitant diseases. Since the pain may have been recurring for weeks, months, or even years before seeking medical attention, the history may be quite long. Pay attention to the events that preceded the onset of pain (family troubles, illness or death of loved ones), concern about pain in the family, the impact of pain on daily activities, including school performance and attendance, as well as the results of previous examinations and diagnoses. The child may understand that the adults around him do not believe in the presence or severity of pain or suspect self-interest behind his complaints.

Why does a child have pain in the chest area and what to do?

Chest pain in children, like pain in other parts of the body, can be triggered by a wide variety of factors. It’s one thing if a child’s chest hurts when he coughs, and quite another if his chest hurts after a fall or severe bruise. In order to correctly determine the treatment, exclude a fracture and prevent the development inflammatory process, urgently take the baby for examination to a medical facility or call a medical team at home.

Chest pain in children is observed much less frequently than headache or abdominal pain. It occurs with herpes zoster (shingles), rib fractures, pericarditis and other diseases.

Children complain of pain in the sternum, but describe their pain incompletely and inaccurately. Therefore, objective examination methods play a decisive role in diagnosis: examination, percussion, palpation, auscultation, x-ray examination, blood test.

Why does a child have pain in the chest area with shingles?

One of the reasons why a child has chest pain may be herpes zoster.

Herpes zoster (herpes zoster; herpes zoster) is a chronic viral infection of humans that occurs with blistering rashes on the skin and mucous membranes. Infectious process controlled by components of the cellular immune system, a decrease in activity of which leads to dissemination of the pathogen with damage to the nervous system and internal organs. The causative agents are viruses of the herpesvirus family, which includes 8 types of viruses that are pathogenic for humans.

The concern is a sharp girdle pain, including in the chest area, accompanied by the appearance of vesicular rashes, usually one-sided, on the skin of the chest along the intercostal nerves. Most of the bubbles subsequently dry out with the formation of crusts, some open and erosions form in their place. Regional lymphadenopathy, nasopharyngitis, laryngitis, keratitis, conjunctivitis, iridocyclitis, chorioretinitis, uveitis, optic neuritis, encephalitis, meningoencephalitis, neuritis, hepatitis, pneumonia, esophagitis, enterocolitis, nephritis, urethritis are observed.

For the treatment of herpes zoster in a child accompanied by chest pain, the following are prescribed: paracetamol - pomg/kg body weight 3 times a day, diclofenac - 2-3 mg/(kg day), B vitamins, acyclovir - 20 mg/day (kg day) orally.

What else can be done if a child has chest pain due to herpes zoster, it is to treat it topically with solutions of aniline dyes (methylene blue, brilliant green), use ointments that have antiviral effect(tebrofen, oxolin, etc.), lotions with interferon.

A child complains of pain in the sternum: why does the chest hurt when a rib is fractured?

Often children complain of chest pain not because of a developing inflammatory process, but because of injuries. So, the cause of chest pain in a child may be a rib fracture.

Fracture of the ribs usually occurs due to the direct action of mechanical force - a fall on a protruding object, a collision with a car, a train, or a car accident. Fractures can be open or closed, single or multiple.

With this pathology, the child complains of pain in the chest area: at rest the pain is dull, while inhaling it is sharp and cutting. The pain intensifies with deep breathing and coughing. Movement of the chest on the affected side is limited. There is a connection with trauma; local pain in the rib area, limited swelling, sharp pain on palpation. The diagnosis is confirmed by X-ray examination.

In order to relieve chest pain in a child, analgesics are prescribed: paracetamol - pomg/kg 3 times a day, diclofenac - 2-3 mg/(kg day); elevated position; oxygen. A consultation with a surgeon is indicated.

For multiple rib fractures accompanied by shortness of breath, cyanosis, and signs of shock, hospitalization in the intensive care unit is indicated. If a child has pain in the chest area due to a fracture with compensated breathing, the victim is hospitalized in a trauma or thoracic department.

The child complains of pain in the chest area on the right and temperature: causes of pericarditis

The child may complain of chest pain on the right side due to pericarditis.

Pericarditis - acute or chronic inflammation pericardium. Distinguish acute pericarditis(less than 6 months) fibrinous and exudative (serous-fibrinous, hemorrhagic, purulent, putrefactive); chronic pericarditis (more than 6 months) exudative and constrictive, characterized by thickening and fusion of the pericardial layers, leading to compression of the heart chambers and limitation of their diastolic filling.

The clinical picture is determined by the underlying disease and the nature of the effusion, its quantity, rate of accumulation and age of the patient. The child's complaints: constant chest pain and fever, symptoms of circulatory failure (swelling, shortness of breath), attacks of severe weakness.

Pain in the heart is one of important symptoms inflammatory lesion of the pericardium. Children over 3 years old indicate the place where exactly they have pain in the sternum, and in infants this is evidenced by attacks of sudden anxiety, pallor, tachycardia and tachypnea. The pain in case of damage to the pericardium is dull, pressing, practically does not radiate to the left, more often it extends to the right and into the abdominal cavity, which makes it considered abdominal. Malaise is noted.

A pericardial friction rub of varying intensity and extent is often heard. The accumulation of exudate is accompanied by the disappearance of precordial pain and pericardial friction noise, the appearance of shortness of breath, cyanosis, swelling of the neck veins, weakening of the cardiac impulse, and expansion of cardiac dullness, however, with a moderate amount of effusion, heart failure is usually moderate. Due to a decrease in diastolic filling, the stroke volume of the heart decreases, heart sounds become muffled, the pulse is small and frequent, often paradoxical (a drop in filling and pulse tension during inspiration).

With constrictive (compressive) pericarditis as a result of deforming adhesions in the atrium, it often occurs atrial fibrillation or atrial flutter, a loud “pericardial tone” is heard at the beginning of diastole.

With the rapid accumulation of exudate, cardiac tamponade may develop with cyanosis, tachycardia, a drop in pulse, blood pressure, painful attacks of shortness of breath, sometimes with loss of consciousness, rapidly increasing venous stagnation. With constrictive pericarditis with progressive cicatricial compression of the heart, circulatory disturbances in the liver and system increase portal vein with high central venous pressure (CVP), portal hypertension, ascites (“Pick’s pseudocirrhosis”), peripheral edema appears.

X-ray examination reveals an increase in the diameter of the heart, and a trapezoidal configuration of the cardiac shadow with a weakening of the pulsation of the cardiac circuit; low wave voltage on the ECG.

If a child has chest pain due to pericarditis, treatment can be conservative and surgical. Etiotropic therapy: antibiotics for infectious pericarditis, hemodialysis for uremia, anti-inflammatory therapy for Dressler's syndrome and connective tissue diseases; cancellation medicines causing pericarditis. To evacuate fluid in acute exudative pericarditis complicated by tamponade, therapeutic pericardiocentesis is performed.

Indications for surgical treatment: chronic exudative pericarditis, relapses of tamponade in acute exudative pericarditis, purulent pericarditis.

If a child has chest pain due to pericarditis, NSAIDs are prescribed: indomethacin - 2-3 mg/(kg day), diclofenac - 2-3 mg/(kg day), ibuprofen - mg/(kg day). It is possible to prescribe glucocorticoids, for example, prednisolone at a dose of 0.7-1.0 mg/(kg day) for 5-7 days, followed by a gradual decrease. The use of prednisolone ensures fairly rapid resorption of effusion. Treatment of the underlying disease.

When a child coughs, the chest hurts: chest pain with pleurisy

Another reason why a child has chest pain may be damage to the parietal pleura.

Pleurisy is inflammatory disease pleura with the formation of fibrinous plaque on its surface or effusion in its cavity. This secondary process is a syndrome or complication of many diseases, but at a certain period it can become more pronounced. clinical picture to the fore, masking the underlying disease.

Pleurisy of an infectious nature can be caused by specific pathogens (mycobacterium tuberculosis, Treponema pallidum) and nonspecific (pneumococci, streptococci, staphylococci, coli, viruses, fungi, etc.) infections penetrating the pleura by contact, lymphogenous, hematogenous.

A common cause of pleurisy is systemic connective tissue diseases (acute rheumatic fever, SLE, etc.), neoplasms (pleural mesothelioma, etc.), thromboembolism and thrombosis in the pulmonary system.

According to the nature of the damage to the pleura, the following are distinguished: dry (fibrinous) pleurisy, characterized by the deposition of fibrin on the surface of the pleura with a small amount of exudate; adhesive (adhesive, productive, fibrous) pleurisy, occurring with the formation of fibrous adhesions between the layers of the pleura; armored (pachypleuritis) - indurative pleurisy, characterized by the appearance of foci of ossification or calcification in the pleura; effusion (exudative) pleurisy, occurring with the accumulation of exudate in the pleural cavity.

According to the prevalence of exudate, pleurisy is: cape-shaped, encysted; by the nature of the exudate: hemorrhagic (serohemorrhagic), purulent, putrefactive (ichorothorax, ichorous); by localization: apical (apical), basal (diaphragmatic), costal, mediastinal, interlobar; by etiology: metapneumonic, parapneumonic, tuberculous, hypostatic, carcinomatous, aseptic, traumatic.

The clinical picture of the disease is characterized by acute, stabbing pain, chest pain when coughing and breathing (intensifies with deep inspiration). Breathing is often shallow, gentle, cough is short, obsessive, dry.

If a child has chest pain when coughing due to pleurisy, paracetamol is prescribed - pomg/kg 3 times a day, codeine - for children over 6 months. 0.002-0.01 g each

Symptoms of the disease - chest pain in a child

Pain and its causes by category:

Pain and its causes in alphabetical order:

chest pain in children

What diseases cause chest pain in children:

Help: calm the child down, let him rest. After some time, the pain should subside spontaneously.

Help: try to distract the child by talking or playing.

Help: since shingles is an infectious disease, it is better to call a doctor at home and not take the child to the clinic, where he can infect other children.

Help: applying heat (heating pad, woolen cloth) to the sore spot helps. For severe pain, you can give a crushed tablet of aspirin or Panadol. Doses are prescribed by the doctor after examination.

Help: to eliminate the cause of pain, it is necessary to treat the underlying disease.

It is reasonable to think about this cause of pain especially when other symptoms of pneumonia are present - cough and fever. If your child has pain similar to pleural pain, consult a doctor immediately.

Help: inflammation of the pleura of an infectious nature is more common in severe forms of pneumonia. The child needs urgent hospitalization.

Help: The child should definitely consult a doctor. If the diagnosis is confirmed, hospitalization is necessary.

Help: the child needs an endoscopic examination of the esophagus, which can only be done in a clinic or hospital. If the symptoms are threatening, for example, sharp pain when swallowing, bloody vomiting, you must call an ambulance.

The cause of this pain is unclear; The pain may be due to tension in the ligaments that attach the diaphragm, the group of muscles that separates the chest from the abdomen, to the ribs.

Pain localized to one area of the chest that becomes tender is likely to indicate a rib fracture, especially if it occurs after a serious injury. Suspicion of a rib fracture is confirmed if pressing on the sternum from the front causes pain in the previously developed area of pain in the projection of the rib.

Broken ribs heal on their own in a few weeks without any treatment. However, if you think your child has a broken rib, see your doctor to confirm the diagnosis and make sure there is no damage to the lungs.

Chest pain is accompanied by other symptoms: frequent cough, slight fever.

Pain caused by a minor blow or injury to the chest persists, but not in an intense form, for more than one day. In such a situation, the pain, although constant, should not interfere with the child's normal activities.

There are frequent moderate chest pains.

Chest pain is severe and constant. The pain is accompanied by a high temperature, above 38.5° C.

The child cannot take a deep breath due to pain.

The child cannot lead a normal life, the child breathes quickly, he does not have enough air, the temperature is elevated.

The child has been hit in the chest or injured, but can walk and move despite severe pain.

Which doctors should you contact if chest pain occurs in children:

Do you experience chest pain in children? Do you want to know more detailed information or do you need an inspection? You can make an appointment with Doctor Eurolab is always at your service! The best doctors will examine you, study external signs and help you identify the disease by symptoms, advise you and provide the necessary assistance. You can also call a doctor at home. The Eurolab clinic is open for you around the clock.

Phone number of our clinic in Kyiv: (+3 (multi-channel). The clinic secretary will select a convenient day and time for you to visit the doctor. Our coordinates and directions are listed here. Look in more detail about all the clinic’s services on its personal page.

If you have previously performed any tests, be sure to take their results to a consultation with your doctor. If the studies have not been performed, we will do everything necessary in our clinic or with our colleagues in other clinics.

Do your children have chest pain? It is necessary to take a very careful approach to your overall health. People do not pay enough attention to the symptoms of diseases and do not realize that these diseases can be life-threatening. There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that, unfortunately, it is too late to treat them. Each disease has its own specific signs, characteristic external manifestations - the so-called symptoms of the disease. Identifying symptoms is the first step in diagnosing diseases in general. To do this, you simply need to be examined by a doctor several times a year in order not only to prevent a terrible disease, but also to maintain a healthy spirit in the body and the organism as a whole.

If you want to ask a doctor a question, use the section online consultations, perhaps you will find answers to your questions there and read tips on caring for yourself. If you are interested in reviews about clinics and doctors, try to find the information you need on the forum. Also register on the Eurolab medical portal to be constantly aware of the latest news and information updates on the site, which will be automatically sent to you by email.

Pain in the chest on the left side (cardialgia) is regarded by patients as cardiac. Often the question “Why does my heart hurt?” worries a person more than the pain itself. There is a positive aspect to this: people understand the danger. The disadvantage is the attempt to independently interpret your symptoms, despondency, and delaying the correct treatment of non-cardiac pathology.

Is cardialgia a symptom?

In diagnosis, the doctor focuses not only on pain, but also on associated symptoms. The condition of suffering is either a signal from internal organs and tissues that have nerve endings, or a pathological focus in a certain area of the brain.

The heart also has nerve endings that cause pain in response to oxygen starvation. However, when you get into spinal cord information about pathology is “blurred”, since impulses from other overexcited zones arrive in some segments.

Let's try typical signs to establish why the pain feels like cardiac pain, and how it differs from true cardiac pain.

Characteristic

Pain is always subjective. Everyone can describe it in words in their own way. If a person is unconscious, then one has to judge the presence and intensity of pain by indirect signs: skin vascular reactions (pallor or redness of the face), blood pressure level.

The most common sign among anesthesiologists is dilated pupils. It is used as a guide when determining the reaction to anesthesia.

Localization

When a patient talks about pain in the heart area, he should be asked to show where, in his opinion, this organ is located. The child does not know anatomy and often confuses the manifestations in the chest (the region of the heart) and in the abdomen.

The reference point for true cardiac pathology is the sternum. Manifestations of true myocardial ischemia are located behind the lower end or on the left.

Atypical localization is possible in the epigastrium, even on the right.

Patient at peptic ulcer and pancreatitis literally “twists”, in this position the pain decreases

Irradiation

The doctor’s obligatory question: “Where does it give?” - allows you to confirm or refute heart pathology.

Angina attacks are characterized by irradiation into left shoulder, elbow, shoulder blade, throat and lower jaw. Often the pain radiates to the arm and fingers.
The shingles nature suggests intervention of the pancreas.
With pancreatitis, it radiates to the back and shoulder blades. A similar nature is associated with herpetic rashes on the skin of the chest.
Inflammation in the lower part of the esophagus radiates to the epigastric region.
With pericarditis, patients report that there is “pain under the heart” and between the shoulder blades.

Description of intensity

Each person has his own pain sensitivity threshold: one suffers heart attack pain for several hours, another is afraid of heartburn. Same descriptions strong sensations are useful in diagnosing acute pain in different areas chest.

Spasm of the coronary arteries is accompanied by squeezing, pressing, burning pain.

Nagging pain is characteristic of myositis, intercostal neuralgia on the left.

Cutting pain is described by patients with perforated ulcer stomach. Due to the high intensity and distribution throughout the abdomen and chest, one may think of a myocardial infarction.

Stitching and aching character have sensations in adolescents with neurocirculatory dystonia or scoliosis, with cardioneurosis, menopausal cardiomyopathy in women.

Duration and frequency

Dull, constant pain is typical for cardioneurosis, neurasthenia, and anemia. They last for days, sometimes increasing and sometimes decreasing.

An attack of angina is distinguished by a clear time limit (no longer than 30 minutes); it depends on the frequency of painful repetitions.

In acute myocardial infarction, pain continues for several hours or even days. The onset of an attack is typical at night or in the morning.

Radiculitis pain relieves when stretching or hanging on a bar

Typical symptoms

The diseases have various additional symptoms.

The intensity of ischemic cardialgia is associated with physical activity, nervous tension. The diagnosis is confirmed by disappearance at rest.
With thoracic radiculitis and osteochondrosis of the spine, pain often occurs when moving, bending the body, turning to the side, or taking a deep breath.
Children and teenagers who have had a sore throat may complain of a stabbing sensation when running, quick games. This is one of the symptoms of the onset of rheumatism. In adults with influenza and other infectious diseases, myocarditis is possible as a complication. In this case, the pain is dull, aching, accompanied by shortness of breath and tachycardia.
If your health deteriorates some time after eating, and you feel nauseous and have pain “under the heart” at the same time, you need to check the condition of the stomach, duodenum and pancreas.
Overeating causes bloating, elevation of the diaphragm, changes the position of the heart, and exerts pressure. Therefore, angina attacks can also be provoked by this factor.
Inflammation in the left lung is accompanied by partial effusion into the pleural cavity. In this case, the cough is very painful, and there is an elevated temperature. Listening to the patient's breathing causes increased pain when sighing.

The rash changes to blisters with liquid contents, herpes is contagious to others

Sharp pain in the heart does not always accompany ischemia. For example, in older people and alcoholics, painless forms occur more often.

Heart pain is most likely to occur in people with high blood pressure, suffering diabetes mellitus. At the same time, patients experience headaches, dizziness, numbness in the arms and legs.

If there is chest pain on the left

Let us summarize the discussion about the diagnosis of cardialgia.

If the pain is associated with physical activity; appear suddenly; are of a pressing or squeezing nature; located behind the sternum or on the left; radiate to the left shoulder, arm, shoulder blade, jaw, then depending on the duration, intensity and reaction to Nitroglycerin, an attack of angina pectoris or acute heart attack myocardium.

cardialgia occurred in a child or adolescent after a sore throat, accompanied by shortness of breath and tachycardia, myocarditis, possibly an attack of rheumatism, must be excluded;
an adult has stabbing and aching pain for a long time due to the flu or another infection, one can think of a complication in the form of myocarditis;
the patient has a fever and a painful cough, then pneumonia should be excluded;
due to pain it is impossible to move the left arm, turn to the side, bend over, the symptoms are similar to osteochondrosis with radicular syndrome;
against the background of “shooting” pains, rashes appeared along the ribs - this disease is called herpes zoster, its cause is a herpetic infection;
prolonged aching is observed, dull pain, irritability, tearfulness, insomnia, sweating, one can assume cardioneurosis, and in adolescents, neurocirculatory dystonia;
there is a clear connection and repetition of pain after eating food (especially spicy or fatty), accompanied by nausea, vomiting, heartburn, you must first of all think about exacerbation of gastritis or peptic ulcer, chronic pancreatitis.

If you have any suspicions, you should consult a doctor, undergo additional examination, and begin treatment. After all, the information provided concerns only typical manifestations. Doctors know of cases where a patient diligently treated his throat, and then was delivered with a massive heart attack.

Sudden, unclear pain requires calling an ambulance.

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Pain and its causes in alphabetical order:

chest pain in children

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Is cardialgia a symptom?

Characteristic

Localization

Irradiation

Description of intensity

Duration and frequency

Typical symptoms

If there is chest pain on the left