Evaluation of cardiac etiology, severity of pain and related factors in children presenting with chest pain

Introduction and Aim: Chest pain is one of the most common reasons for referral to a health institution in children. Families are concerned because they think that the pain is mostly of cardiac origin. As a result, this situation causes repetitive applications or referrals to a higher level facilities. Cardiac causes of chest pain in children are very rare; it may be mostly of musculoskeletal, psychogenic, respiratory and gastrointestinal origin. An important part of it is considered as idiopathic. In our study, it was aimed to evaluate the applications made to the Dicle University Pediatric Cardiology outpatient clinic with complaints of chest pain. Materials and Methods:In our descriptive and cross-sectional study, 244 patients aged 5-18 years who applied between 01.01.2020 and 31.12.2020 were evaluated prospectively. Chest Pain Patient Evaluation Form of the pediatric cardiology outpatient clinic and Wong-Baker Faces pain scale were used as data collection tools. The obtained data were analyzed using the SPSS 22.0 package program. Results:Half of the patients were girls. The mean age was 139.5±41.4 months. Cardiac etiology rate was 8.2%. Mitral valve prolapse is the most common (45%) cause of cardiac chest pain. Non-cardiac causes are as follows: psychogenic 27.9%, musculoskeletal 22.1%, respiratory 13.9%, gastrointestinal 2.9%, other 1.2%. The rate of idiopathic ones was determined as 23.8%. While no significant relationship was found between the causes of cardiac chest pain evaluated with the Wong-Baker pain scale, it was determined that the pain intensity felt by girls was in a wider range than that felt by boys. Conclusion:Although cardiac etiology is rare in children, it is of vital importance. Therefore, patients who present with chest pain should undergo a careful anamnesis and physical examination, and patients who are thought to be at cardiac risk should be referred to the pediatric cardiology department for detailed examination. Although there are current studies on chest pain in children, the basic data belong to very old publications. There is a need for wide-ranged studies that will have been up-to-date thedata and studies to shed-light to chest pains of unknown origin. Keywords: Chest Pain, Child, Cardiac Etiology