$Unique_ID{PAR00035}
$Pretitle{}
$Title{Medical Advice:  Chest Pain}
$Subtitle{}
$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Chest Pain breath shortness fever cough blood flecks prostration
pleurodynia Pleurisy pneumonia breathing difficulty coughing pneumothorax
diaphragm hernia Heart pain armpit}
$Log{}

Your Child:  A Medical Guide


Chest Pain


     Quick Reference

     SYMPTOM
     - Pain anywhere in the chest

     HOME CARE
     - Give aspirin or acetaminophen.
     - Apply gentle heat with a heating pad.
     - If chest pain or soreness is caused by hard or frequent coughing, cough
       medicine may help.

     PRECAUTIONS
     - If chest pain is accompanied by shortness of breath, high fever, a
       cough producing blood flecks, or prostration (collapse), get medical
       help immediately.
     - If there is persistent pain beneath either armpit that is made worse by
       breathing, see your doctor.
     - Do not give cough medicine if the child is having difficulty in
       breathing.


     Chest pain is common during childhood.  Although chest pain in adults can
be serious, it is rarely a symptom of serious disease in children.
     A very common form of chest pain in children is the so-called stitch in
the side--a stabbing pain in the lower chest, more often on the left side than
the right.  This pain occurs with exercise and will stop after a minute or two
of rest.  This type of pain may be caused by gas pains in the large intestine,
contraction of the spleen, or spasm of the diaphragm (the muscular partition
between the chest and abdominal cavities).  Regardless of the cause, it is
harmless.
     Pain in the area of the sternum (breastbone) is common when a child has
bronchitis or a head cold combined with a cough.  A frequent, hard cough often
makes the diaphragm sore, causing a pain just below the ribs.  Pain on one
side of the chest may be caused by pleurodynia (pain from inflammation of the
muscles between the ribs) or by shingles.
     Injuries to the chest area may cause pain that is worsened by deep
breathing and movements of the chest.  While the discomfort may be the result
of a muscle strain or bruise, a physician should rule out other possibilities,
such as a fractured rib.
     There are a few causes of chest pain in children that are more serious,
but these are also uncommon.  Pleurisy (inflammation of the lining of the
chest cavity) that develops as a complication of pneumonia may cause chest
pain, accompanied by fever, difficulty in breathing, and coughing.
     Another more serious cause of chest pain is spontaneous pneumothorax,
which occurs when a small bubble on the surface of the lung bursts and air
escapes into the chest cavity, causing gradual collapse of the lung.  This
condition comes on suddenly, often with sharp pain, and causes increasing
shortness of breath.
     A hernia of the diaphragm causes chest pain that is usually worse when
the child is lying down and that lessens or is absent when the child is
sitting or standing.
     Heart pain in children, even those with serious heart conditions, is so
rare that it is practically unknown.

SIGNS AND SYMPTOMS

     Chest pain may occur alone or with other symptoms.  The exact location of
the pain and the circumstances that bring on or worsen the pain are clues to
the type and cause of chest pain.  Other symptoms (cough, fever, rash at the
site of the pain, and shortness of breath) are also clues to the cause.

HOME CARE

     Most cases of minor chest pain can be treated at home with aspirin or
acetaminophen, mild heat, and reassurance.  If chest pain is caused by a hard
cough, cough medicines may help.  Pleurisy, spontaneous pneumothorax, and
hernia of the diaphragm should be treated by a doctor.

PRECAUTIONS

  -  If chest pain is accompanied by shortness of breath, high fever, a cough
     producing blood flecks, or prostration (collapse), get medical help
     immediately.
  -  If there is persistent pain beneath either armpit that is made worse by
     breathing, see your doctor.
  -  Do not give cough medicines if the child is having difficulty in
     breathing.

MEDICAL TREATMENT

     Your doctor may recommend x-ray examination of the chest and blood
studies.  Pneumothorax is treated by hospitalization, close observation, and
possibly puncture of the chest wall to remove trapped air.

RELATED TOPICS:  Bronchitis; Pneumonia; Shingles; Viral infections