6 Questions to Ask When Your Child Complains of Chest Pain

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I see this scenario quite frequently in cardiology clinic. Generally speaking, about a quarter of my new patient visits complain of the following set of symptoms at their appointment:  chest pain lasting for several months, maybe 2-4 times a week, for less than 10-20 seconds at a time, at a moderate intensity, sometimes with activity, but more often not. And the child just recently told his or her parents about it.

Understandably, the parents are worried.

But the good news is that while it’s pretty common for children to say that their chest hurts or even that their “heart hurts,” it’s rarely caused by heart disease.

Most kids will complain of chest pain sometime between age 7 and their teenage years, but thankfully, it will be caused by an underlying heart condition in less than 1% of them. More frequently it is related to a viral illness, stress, or most commonly, musculoskeletal pain.

It is my hope that this information will give parents a little peace of mind: the pain manifesting in your child’s chest is rarely caused by heart disease. But I also understand how concerning it can be for parents, and sometimes further investigation may be necessary to narrow down the cause. So where should parents start?

I suggest answering the following questions:

  1. Has my child been sick recently?
    One of the more common causes of chest pain in children is from costochondritis. This is a condition characterized by inflammation in the joint between the breastbone and the ribs, typically caused by a viral illness or frequent coughing. Costochondritis is not concerning, but in some cases it can be long lasting and your child may need a prescription anti-inflammatory to get rid of it.
  2. Was my child injured recently?
    If your child was hit in the chest during a sporting event or even a fall, this could be a more obvious cause of the chest pain. However, even heavy lifting, frequent coughing, or intense aerobic exercise can strain the rib muscles and cause chest pain. You’ll want to contact your pediatrician if the pain is severe, persistent, or associated with difficulty breathing.
  3. Is my child stressed?
    While it might be difficult to imagine a 7-year-old being stressed, school pressures and the loss of a loved one, for example, can all contribute to feelings of stress. What may be even more surprising is that stress can cause chest pain. While chest pain caused by stress is harmless – it’s really no different than a stress-related headache – the duration of the pain is understandably worrisome for parents.
  4. When does it hurt?
    Does it hurt when your child is sitting down, or only when he or she is active? Chest pain from non-cardiac causes usually happens both when a child is at rest and when they are active. My first question is often whether the pain occurs during gym class or while watching TV. Chest pain that only happens with or immediately following moderate to vigorous activity, such as while running and playing competitive sports, is a different matter which does warrant further medical investigation.
  5. How long has it been hurting?
    Has it been going on for months or even years? If yes, then it is almost certainly not caused by heart disease. Chest pain caused by cardiac disease is either so severe that no child could cover it up or ignore it, or it is progressive and associated with other problems such as passing out or worsening fatigue, that it would be highly unusual for the symptoms to continue over several months. However, non-cardiac chest pain is the very opposite; it can often by ignored, is not associated with other concerns, and often just lingers in the background.
  6. How painful is it? Mild-to-moderate or severe?
    Typically mild-to-moderate chest pain is not related to the heart, and isn’t a cause for concern. However, the more concerning chest pain is when the pain is sudden and severe. Typically it will hurt so bad that your child will not want to go to school and will look like he or she is struggling with the pain. This kind of pain is most often caused by pericarditis, which is an inflammatory condition of the heart. Thankfully, pericarditis is very rare. But what’s interesting about it is that it’s the most common reason that a child’s chest pain is related to the heart. If your child has sudden onset of severe chest pain that is continuous and often occurs around the same time of an illness – contact your child’s pediatrician that same day.

The vast majority of the time, chest pain in children is not related to the heart. While there is no single medical history question or medical test that can determine the source of chest pain, hopefully the six questions discussed above can help parents and teens narrow down what’s potentially worrisome and what’s not. If you have any concerns at all, schedule an appointment with your pediatrician, and have your answers to the above questions ready. They will help steer your pediatrician in the right direction.

Editor’s note: For more frequent heart and health-related thoughts, follow Dr. Madsen on twitter: @MadsenNicolas

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Dr. Nicolas Madsen

About the Author: Dr. Nicolas Madsen

Nicolas Madsen, MD, is a cardiologist at Cincinnati Children’s Heart Institute, with special interest in the prevention of cardiovascular disease. He is focused on research and community outreach programs to find better ways to screen and educate children and adolescents regarding their risks for heart disease or sudden cardiac arrest.

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  1. heid September 29, 14:42
    Hi, I have been struggling with my nineteen year old daughter for months with severe chest pain, and fatigue. she gets winded when walking up and down stairs, and can't catch her breath after a mile run. She has seen a cardiologist, and a pulmonologist, both of whom have said her heart and lungs are healthy, and no asthma, yet the pain and breathing difficulties persist. Now, she is complaining of tenderness in the area of her spleen. She has had recent blood work, and all is normal. To my knowledge she abstains from drugs and alcohol, and does not smoke. She is not a complainer, and has run 25 miles on a broken ankle, only complaining of some pain..... I am at my wits end. I don't know were else to turn. Last night she called crying begging me to help make the pain stop. Any suggestions??
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author October 02, 08:34
      Hi Heid, Without evaluating your daughter, it would be difficult for me to make a recommendation. It may be worthwhile to seek a second opinion from another subspecialty area that she has previously seen. My heart goes out to you and your family.
  2. HEATHER October 30, 17:43
    My ten year old daughter for last 2 years has complained of chest hurting. This acquires at no given notice just occurs out of the blue. Her father had WPW and a great grandma with Huntington Disease. She was born early due to heart rate very low and under stress, so had an emergency C-section. I am wondering if she may have something wrong or if this is something not to worry about. Thanks
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author October 31, 09:02
      Hi Heather, I suspect that the chest pain your daughter is experiencing is not cardiac at its source. I am reassured by the fact that it has been going on for 2 years without worsening progression and that it does not occur only with exertion. However, the ability to make any confident diagnosis and prognosis without a physical exam is difficult. I would explore this question with her primary care physician first. If there is concern after that visit, they can refer you to the appropriate provider.
  3. nayely November 05, 14:04
    My daugther is 8 and she complains about bothe of her ribs hurting what can it be
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author November 12, 10:13
      Hi Nayley, hard to know exactly what it could be but it sounds most likely to be musculoskeletal chest pain based on your short description. If this is bothering your daughter or has been going on for some time, I would recommend bringing her to her primary medical doctor for a physical exam. He or she may be able to recreate the pain with chest palpation which would be consistent with a muscular source to the pain. Best of luck and thanks for reaching out.
  4. Melissa November 09, 01:16
    Hi my 8 year old daughter has been waking up at night complaining of chest pain it doesn't last very long because she falls back to sleep pretty quick. This happens about 3 times a night. Her last check up I was told she was a little over weight. Should I be very concerned?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author November 12, 10:08
      Melissa, your question regarding your 8 year old daughter is an important one. What makes your question unique is the fact that the pain is causing your daughter to wake from sleep. While I am not certain as to what may be ailing your daughter, I would encourage you to speak with her PMD about this question. While chances are greatest that the pain is not cardiac in nature, it would be important to rule out something like a heart rhythm disturbance. Since these events are nightly, this should be possible with a simple heart rate monitor such as a Holter. Best of luck and thanks for reaching out.
  5. Chris Russell November 11, 15:08
    Dr., Our 8 year old son has complained a few times over the past year about his "heart hurting" when he runs a lot. (Happened at recess a few times i know of) Just recently he has been practicing for a basketball team the past (3) Sundays in a row. EACH time at the end of practice when they would do a scrimmage he would grab his chest toward the end and hold back tears. He is the kind of child that refuses to cry in front of people if at all possible too. He tells me that it feels like somebody is "Squeezing his heart behind his chest" I have felt the heart beat and it did not seem to be beating too fast. Powerful yes but that seemed normal to me due to he has been running back and forth non stop. He does NOT cough. The pain goes away about 10 minutes or so after he stops the running. The only time he complains about he pain is when he is severely active. I just set up a DR appointment with his pediatrician this week but found this site and wanted your thoughts if you would be so kind as to reply. Thank you in advance, Chris.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author November 13, 14:07
      Hi Chris, thanks so much for your question. Glad to hear that you have an appointment with your son's doctor this week because that is the best first step. I would not be too surprised if the doctor recommends a visit with a pediatric cardiologist. The reasons I suspect that a referral is likely is the consistency of the symptoms and the fact that these symptoms occur exclusively with exercise. However, please also be aware that despite the comments of "heart hurting" and "squeezing behind the chest", the most likely reason for this pain remains non-cardiac. That does not mean you should not see your doctor (because you should); it just means that even in circumstances such as your son's, the usual cause of the pain is the muscles and bones in the chest.
  6. Heather Clouston November 14, 15:33
    my 11yr old son has been complaing of pain in his heart for the past 3 days since having the flue jab.they come and go regular even when he is just resting.he was playing on his xbox this evening when he had a sudden sharp pain,he paused his game and had a few tears .he has type1 diabetes so not sure what to do as he seems fine inbetween .
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author November 21, 13:07
      Heather: Did your son have a flu shot or the actual flu illness? If it was merely a flu shot, then the recommendations are not any different regarding the chest pain – very likely to be related to muscular-skeletal pain (even in the setting of diabetes). However, if the chest pain is the result of a recent flu illness, the chances for pericarditis are higher. In the case of worry for pericarditis, I would have your son visit his doctor if the symptoms have persisted (if they have resolved, then you should be fine to watch for changes at home). Thanks for the question – hope that helps.
  7. Brittany Coll November 19, 18:53
    My son is 6 years young he has been complaining of his heart hurting as you stated. We will be watching a movie for example and then he will start to cry for he Is in pain. I will feel his chest and it beats pretty hard and fast. Is this common
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author November 21, 12:41
      Brittany: While your son's age is a little younger than typical, it is not that unusual to hear of chest pain in elementary school kids (or "heart pain" as your son describes). What is very reassuring is that these episodes for your son occur while resting (watching TV). Regarding the sensation of the heart beating hard and fast, this is a common description for a 6 year old. A normal heart rate in this age group is 80-120 beats per minute, and when your son is in pain, I would not be surprised if the rate was around 120 bpm (and that feels fast). However, on rare occasion, children do have heart rates that are elevated beyond what is expected and the source may be an arrhythmia. Typically these heart rates are faster than 180 bpm. Next time you notice your son express chest pain, try to count his heart rate (which is easier said than done) and see if the rate is closer to 120 or 180. The way to count the heart rate is to put your hand on his chest (or feel his pulse in his wrist) until you can reliably count each beat and then simply count the number of beats for 60 sec (or count for 30 sec and multiply your count by 2). Hope that helps and thanks for your question.
  8. Rebecca Luper November 19, 23:09
    My son is eleven, yesterday while sitting down he had a sharp pain down his left arm and wrist that brought him to tears......tonight he woke up complaining if sharp pains in his chest and that his left wrist and leg were hurting...i am going to be scheduling an appt with his doctor in the morning but am wondering in the meantime what that cld be from or if it is normal as well for his age at times.....thank you
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author November 21, 12:40
      Rebecca – What you describe (chest pain that is sharp, painful enough to bring a child to tears, and with associated areas of pain) is not actually that uncommon. If your child has an otherwise healthy medical history and is not experiencing these symptoms in association with exertion, I suspect strongly that the pain is not heart related. Of course, checking this out with his doctor is always a good idea. Without the ability to examine your son, I can only speak in generalities, which means I can tell you that the vast majority of chest pain cases like your son's are not heart related. Hope that helps. Thanks for your question.
  9. Teresa Kittle November 22, 17:21
    my granddaughter has had chest pains when she runs for 4 years. The heart Drs say that she her heart is find. She is 10 years old, she wants to play sports but if this keep up I don't know if she can. Please can you tell us what to do? Heart problems runs really high on my side of the family.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author November 26, 13:03
      It sounds like your granddaughter has seen a cardiologist. If that physician thought your granddaughter's chest pain was not heart related, I think you can take comfort in that assessment of her health. There are many other, and much more common, reasons for chest pain in children than those that are heart related. Being active is so important to long term health and I would hate to keep your granddaughter from continuing to set a great example for other children. However, if you think her chest pain related symptoms are changing, or new information is available about your family history, then you can always consider asking her primary doctor about her chest pain. Without the ability to examine your granddaugther, I can only speak in generalities, and my thoughts should not replace what can be gleaned from a clinic visit.
  10. Rebecca November 22, 22:31
    My daughter is 8 years old. She has been complaining about chest pains for about 3 weeks. Usually when she is sitting down resting or asleep. She also gets very winded during PE in school. She wakes up at night crying usually because of her chest. Some nights it's her hips. I was wondering if these pains could be associated with growing. She is average height but higher up on the weight scale for her age. Though that is not due to being fat in my opinion she is just wider then most kids her age. The left side of her chest does seem to protrude farther out then her right by only a little but as a female I would assume that's normal because most people ( obviously more noticeable in females) are not symmetrical. Is this something that I should be worried about and take her to the er or can it wait until her Dr is back from vacation
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author November 26, 13:01
      As you point out in your question, your daughter's experience with chest pain is of the more typical variety as it occurs during periods of rest. In addition, I think your intuition regarding the pain at night as it compares to her hip pain is likely to be accurate. Consequently, I think a visit to her doctor makes the most sense. My preference for a clinic visit over a visit to an ER for typical chest pain of childhood is because the ER visit can often lead to over testing and no real resolution. Of course, if you are noticing other new concerns while waiting for your doctor's appointment (such as passing out with exercise), then a visit to the ER is most appropriate. Without the ability to examine your daughter, I can only speak in generalities, and my thoughts should not replace the information that can be gleaned from a clinic visit.
  11. Nichole Jackson November 25, 21:25
    My son is 6 years old and has for the past 2-3 weeks been complaining and crying with his chest hurting. It happens when he's at recess or active but not everytime. I took him to the Dr. who ordered a chest x-ray and an EKG. The EKG came back abnormal with a junction escape rhythm and he is being sent to a cardiologist now. My question is that I have never heard of this and I have looked online but I cannot make sense out of what I am reading, they use a lot of abbreviations and things that may make sense after we see the cardio. In the meantime, is there anything you can tell me to help me understand a bit better please. I am extremely worried about him and what I should expect in this process.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 02, 08:35
      Nichole: Sorry to hear that your son needs to be seen by a cardiologist. I can appreciate how scary this must be. It is a little hard for me to comment on the specifics of your son’s case without the aid of looking at the EKG. What I can say is that a junctional escape rhythm means that during the period when the EKG was performed, your son’s heart was not following the “orders” of the sinus node in regards to when to beat (which is the normal circumstance). Instead, the heart was beating according to “electrical messaging” provided by the junction of his heart, which is located in the ventricles (sinus node is located in the right atria). What I would expect is that your cardiologist will want to monitor your son’s heart for 24 hours with a Holter monitor (can be done at home). In addition, the cardiologist may also want to perform a cardiac ultrasound (called an ECHO). I would hope with a little testing the specifics of your son’s situation will be made more clear. Hope that helps a little.
  12. am November 26, 18:24
    My 13 year old has had sternum pain for almost a month. we think its from a blow to the chest from field hockey and then bumping the same area twice thereafter. We've been to the er and 4 other drs. been told three time its costocondritis. Motrin has not helped. Voltaren gel has not helped. Just been put on Mobic two days ago. Had a CT scan of sternum. no fractures found per ortho dr. how long does it take Mobic to work? can this be something else she has?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 03, 10:27
      Dear am: It certainly sounds like you are doing all the right things for your active daughter. I have never personally used Mobic for this type of pain, although I can certainly understand the reasoning behind that choice. The trouble with these type of injuries can be the duration it takes for complete healing and pain relief. It sounds as if you and your daughter's medical team have properly identified the source of the pain, so now it is just a waiting game (while finding a way to keep your daughter active and as pain free as possible). I do not suspect that the pain is from anything else. Hopefully the Mobic will dull the pain until it resolves on its own. Without the ability to examine your daughter, I can only speak in generalities, and my thoughts should not replace the information that can be gleaned from a clinic visit. Best of luck.
  13. Miguel Espinal December 01, 14:56
    My son has been having chest pains since February 2014, at first it was diagnosed as growing pains, upon further test, we discovered he had PAPVR. This was something that without test would have been impossible to detect. On August 8, 2014 he had open heart surgery to correct this. All went well, Thank God. However after a couple of weeks his chest pains continued like before. He was on medication for some rubbing due to original enlargement and the chest pain was dismissed in order to focus on his heart pains. After a couple more check ups his heart test come back normal. Yet his chest pains are typically worse, they last for long stretches at a time and daily. He can not focus for more than an hour or so at a time. His school work is suffering. Can growing pains be that bad, on the average his pain is 5, it usually concerns me when he says his pain is 7 or 8 and he even crys. His physicians have said its growing pains. He doesn't like to take Motrin, as he says it doesn't really make a difference, and only takes it when the 7 and higher pains compel him to try and cope with the pain. Should I take a more aggressive approach with his physicians to look beyond your growing pains.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 03, 10:31
      Hi Miguel: To be honest, you ask a tough question. It is hard for me to provide a definitive answer based on having limited access to your son's data. With that in mind, here are my thoughts: It sounds like your son's pain has been going on for some time, and that correcting the PAPVR did not fix the source of chest pain (for others reading this – PAPVR is a congenital heart condition that a child is born with and has had all his or her life up until corrective surgery). That part of your son's story does not really surprise me as I do not think of PAPVR as causing pain in the first place (of course, once discovered it should be corrected as in your son's case). I just think PAPVR was not the source of your son's original pain. However, why does the pain continue? I have certainly seen chest pain from muscular-skeletal reasons last a long time; sometimes the pain lasts 1-2 years. So the duration of the pain does not mean that the source is not "growing pains" or the muscles and bones in the chest wall. On the other hand, it sounds like your son had some issues with pericardial effusions and inflammation post his surgery (if I am interpreting your question correctly), and that can certainly cause chest pain as well. I have certainly had some patients that continued to have chest pain even after the pericardial fluid resolved, in fact one of them had PAPVR surgery. Therefore, here is my advice – most likely the pain is simply a continuation of the muscular-skeletal pain that existed prior to surgery and it might just take a long time to resolve. But if nothing is helping and the pain is negatively impacting your son's life, you should discuss with your son's cardiologist the medication Colchicine for the pain. (Important note for other readers – I am specifically recommending Colchicine in the case of Miguel's son as he has had some chest pain after heart surgery with issues related to fluid around his heart, this is not a medicine I use for general chest pain without that history) The cardiologist may or may not have tried this medicine before for this reason as this medicine is most commonly used for gout. But it may be an option. I would trust your cardiologist above my recommendation as I do not have the privilege of seeing your son in clinic. I hope that helps and best of luck with his recovery. Without the ability to examine your son, I can only speak in generalities, and my thoughts should not replace the information that can be gleaned from a clinic visit.
  14. Banesa December 01, 21:19
    Hello my daughter is 7 and for the last 3 weeks she randomly complains to me that her heart is burning and she feels a sharp pain in it. When she complains I notice that she is either lounging around or has eaten. She's in perfect weight range and has been healthy her whole life. Any answers would be great thanks!
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 03, 10:20
      Hi Banesa: Typically when I hear a child describe “burning” or “sharp” pains (especially after eating), I suspect heart burn/reflux may be a cause. It sounds like she is an otherwise healthy girl. So often when a child feels chest pain, they will use the word “heart” to describe the location. But as you know from reading this blog and some of the answers to previous questions, thankfully the pain is almost never the heart during childhood. If this pain seems to continue, I would talk to her doctor about heart burn as a source and consider some potential therapies (not all meds per se – some other options are available). Hope that helps. Without the ability to examine your daughter, I can only speak in generalities, and my thoughts should not replace the information that can be gleaned from a clinic visit.
      • Banesa December 03, 11:25
        Thank you so much for taking the time to reply to me. I will speak about acid reflux with her pediatrician. Thank you once again.
  15. Brandee R. December 08, 21:28
    Hello, my 6-year old daughter has complained a few times over the past year of her "heart hurting" and "bumping hard" and "squeezing of my heart". Sometimes she is able to go to the bathroom (#2) and seems to help....but I wonder if there may be an underlying heart condition. It scares her, which in turn scares me to death. The episodes only last a few minutes at a time and she is not active prior to them that I know of. Her heart rate seems fine, strong, but fine. Could these be palpitations? Or some kind of reflux? Do you recommend she see her pediatrician?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 10, 13:25
      Hi Brandee, I do think this is something to talk to your pediatrician about. It's always hard to know precisely what a 6 year old means when they discuss their own health – my kids like to tell me they have things like "the worst leg pain in the world", and then a few minutes later they are running and playing in the backyard without hesitation. However, given the repeated statements, it does seem an evaluation is indicated. I suspect that the sensations are the result of some normal process but it could be because of something like palpitations. The trick will be proving the cause. Cardiac rhythm measuring devices like a 24-Holter monitor or an event recorder are great if the episodes are semi-frequent. When the episodes are more rare, as is the case for your daughter, they can be hard to capture. Sometimes an EKG is helpful even when the events are not present – I will leave that discussion for you and your pediatrician. Without the ability to examine your daughter, I can only speak in generalities, and my thoughts should not replace the information that can be gleaned from a clinic visit. All the best and Happy Holidays.
  16. Amy December 09, 23:14
    My 6 yr old is complaining his "heart hurts" along with his abdomen and sometimes stomach. The pain seems to come and go, sometimes when laying down, sometimes when playing. His grandfather has had 2 heart transplants due to cardiomyopothy. I'm going to make a dr apt but should I be worried or is this still "normal?"
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 15, 08:30
      Hi Amy: Sorry for the delayed response. What separates your question from that of many of the previous ones is the history of cardiomyopathy in a direct relative. While the complaints you describe sound typical of some commonly reported non-cardiac symptoms in your son's age group (stomach and chest pain together), the family history changes my thinking. Do you know what type of cardiomyopathy his grandfather had? If it was something like dilated/restrictive/hypertrophic cardiomyopathy, then a more complete evaluation may be necessary. In fact, is this a paternal or maternal grandfather? If this is your father, then even without symptoms, it might be a good idea for your son to be evaluated. Unfortunately, at this time, I probably have more questions for you than answers, and consequently, this is probably a good time for you to talk to your son's doctor about appropriate next steps. Sorry I could not have a more simple answer.
  17. emma canas December 11, 00:34
    My son is 10 uears old complains of pain upper left chest and sharp pain in his heart he says. Hes is been jumping the rope does about 200 jumps per night because hes overwight. He has asthma and takes albuterol as prn but asthma is controlled right now only this pain he has on his chest and also headaches about 3 x a week we wanna have him see a Dr. Should we see a cardiologist?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 15, 08:26
      Hi Emma, Good question. It sounds like your son is doing the right thing by taking charge of his health and getting more exercise. Kids with asthma often can develop chest pain with strenuous exercise like jumping rope. This is likely made even worse if your son has previously not been that active. If the pain is really bothering him, or keeping him away from exercise, then a visit to his regular doctor could be a good idea. It is not so much that I worry that the pain is heart related, but rather that his doctor can adjust his asthma medication to allow him more freedom to exercise free of pain. Hope that helps. Without the ability to examine your son, I can only speak in generalities, and my thoughts should not replace the information that can be gleaned from a clinic visit.
  18. bernadette December 11, 07:19
    Hi my son was a premiee born five months gestation he has ephazimia latley hes been saying hes getting chest pains n pain in left arm Dr says hes ok should I be worried
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 15, 08:27
      Hi Bernadette, Sounds like your son has been through a lot already in his life. I am always amazed at the great advances in the neonatology field of medicine. Does your son have chronic lung disease? You mention he has emphysema and I wonder what the general state of his lung health is at this time. Certainly just like case of asthma, emphysema can be the cause of chest pain, especially with activity. This is probably a good question for his regular doctor who may be able to adjust some medications. Hope that helps. Without the ability to examine your son, I can only speak in generalities, and my thoughts should not replace the information that can be gleaned from a clinic visit.
  19. Frances Napolitano December 11, 22:48
    I was trying to find some info on chest pains for teenagers and came across your q&a. You seem too nice to be a doctor. Not trying to offend you but sometimes doctors seem so desensitized or cold. Just wanted to say that you sound like a keeper. Thank you for taking the time to answer parent's questions.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 15, 08:25
      Hi Frances, Thanks so much for the positive feedback and kind words.
  20. Tiffany December 12, 02:45
    4 yr old boy. says his heart is broken or hurting. it's been going on for roughly a year now. He was seen, quickly evaluated, regular size heart, nurses did a quick monitor to see the rhythm, they said it was normal. Yet the pains go on, if he's lucky, he'll go a day without pain. But on a normal day, he says it hurts 2-5 times a day. It hurts whether he's playing or sitting around. When it hurts him, he just lies down on the couch or bed or just looks weak, but a few minutes later he's up and about again. The past couple day's tho, he's been asking for motrin and I'm assuming that it's helping him because he doesn't say anything about pain. Sometimes his chest pain is accompanied with nausea. I've done some researching, and i'm reassured that i don't have to be worried, but i'm just confused on what this pain can possibly be.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 15, 08:22
      Hi Tiffany, 4 years old is certainly a little less common in regard to worries about chest pain. It sounds like you have spent some time trying to address this pain (visit to the doctor and research online). Since this has been going on for roughly a year, it would be surprising that it was getting worse as it relates to his heart. I agree with you that this likely is not heart related. I wonder if anyone else in the family has chest pain (adults), and your son has learned to mimic some of these behaviors? Now if the pain continues or worsens, the only possible heart related concern I can think of is brief palpitations that might feel strange and his 4 year old thinking calls that strange sensation pain. If that is the case, a 24 hour heart monitor could answer the question of normal versus abnormal (assuming his pain happens in that 24 hr period). However, as you suggest, this is unlikely to be heart related. Hope that helps. Without the ability to examine your son, I can only speak in generalities, and my thoughts should not replace the information that can be gleaned from a clinic visit.
  21. Jaime Chavez December 16, 12:35
    Hi, my 9 year old nephew a month ago was told he had an abnormal heartbeat, then two weeks ago complained about chest pains in gym glass and was told again by the doctor he had abnormal heartbeat... Be has been referred to a cardiologist but was seeing if anybody new what it could be?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 18, 16:40
      Hi Jamie, It's tough to know exactly what this could be at this time. Abnormal heartbeat can mean different things to different people (even between doctors). I have certainly had patients in the past with a previously described "abnormal heartbeat" that turned out to be totally normal. It sounds like he has been referred to a cardiologist, which will hopefully help sort out some of the details. Sorry that I can't offer much of an explanation at this time.
  22. Jaime December 18, 10:46
    I have a 7 year old daughter who was diagnosed with a PDA at age 6. She had it closed January 2014. I took her to her PCP because she was having blue lips after showering or getting out of the pool. Her doctor told me it was because her skin was so fair. However she referred us to a cardiologist who found the PDA. The only symptom she displayed was fatigue and would sleep for hours at a time and poor weight gain. She continues to do well to this day, very active and plays sports. For the past week she has been complaining of her chest hurting and when she breathes it makes her head hurt. She has not ran a fever and has not really been coughing much. She is not do for a cardio check up till June 2015. Just wondering if I should be worried. FYI the lining of her lips will have a bluish tint but then it goes away. Its bizarre but she doesn't seem to be in distress. Her doctor told us a couple of months ago her murmur was back but did not refer us to her doctor. I guess I am looking for guidance on what to do. Thanks
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 22, 06:17
      Jaime: My comments below are assuming that you have had your daughter's PDA device closure checked since the procedure in January (maybe a clinic visit with an ECHO about 1 month or more after the procedure). If you have not had such a visit since the procedure, then I would advise that you should see her cardiologist before the currently scheduled visit in June 2015. On the other hand, if there has been an ECHO to confirm that the PDA closure device is in place, then I suspect your daughter is in good shape and her current symptoms are not related to her heart. It would be very unusual for the device to fail or move more than 1 month after an originally successful procedure. All the while, as you can see from other questions to this blog, chest pain is common in kids (as is peri-oral cyanosis, the fancy term for the normal response in some kids to develop blue lips especially when cold challenged). Regarding the murmur, those are common in kids and benign in the majority of cases. A PDA murmur has an easily distinguished quality, and I would suspect her new murmur is not a PDA type. If her murmur truly is a PDA type, then moving that clinic appointment to earlier in 2015 would make some sense. Without the ability to examine your daughter, I can only speak in generalities, and my thoughts should not replace the information that can be gleaned from a clinic visit.
  23. F. Azali December 20, 10:22
    Hi, My 6 year-old girl loves to run. Recently, she has been complaining of chest pain and palpitations whenever she runs even for a short distance in the house. There has never been any fainting episode. According to our primary care physician, my daughter's heart sounds are normal. Apart from allergic rhinitis, she is not known to have any medical illness. Should I bring her to see a cardiologist for further evaluation?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 22, 06:14
      F. Azali: Thanks for your question. As you might have read in some of my previous responses on this blog, I think this type of question from a 6 year old is a little more tricky than from a 14 year old. For one, the reasons for chest pain are a little different in your daughter's age group, and two, it can be more difficult to discern what exactly the 6 year old is noticing (palpitations in this age group may represent abnormal heart beats or simply the observation of normal beats that are more noticeable when the heart is working harder during exercise). Certainly in your daughter's case, it sounds like she is having consistent symptoms only with exertion. While it sounds like (from your description of the visit to your daughter's doctor) she has a normal heart exam in the clinic free of murmurs and premature or irregular heart beats, this alone does not eliminate the possibility of the heart as the source of her symptoms. I think you could take one of two approaches: 1) you can keep an eye on your daughter and see if her symptoms disappear on their own (as they often do in this age group), or 2) you can have her checked by a cardiologist. I suspect that a visit to the cardiologist would include an EKG, and what is done after that would depend on your conversation with the cardiologist and the physical exam. In cases like this, I would go with what feels right. If you and her doctor are reassured and comfortable, then I think a "wait and see" approach is very reasonable. However, if you feel unsure, then a visit to the cardiologist may offer more peace of mind. Hope that helps.
  24. julia December 20, 16:09
    hi my daugther is 11 yrs old have been complaining for 2 weeks about her heart it feels like she cant breathe and heart rate sometimes is fast she also said i heart felt like it stopped . this is like a on and off thing thru the day .what could it be.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 22, 06:13
      Julia: Thanks for your question. Hard to know exactly what this could be from your description. If she is an otherwise healthy 11 year old, this sounds mostly like common non-heart related chest discomfort. That is assuming that none of these episodes is associated with passing out. I would try to count her heart rate during one of these episodes by feeling her pulse (wrist below the thumb is the easiest place, count the beats for 20 seconds and multiply by 3, and practice during normal times first to get the hang of it). I am sure that her heart rate speeds up normally during these episodes because of discomfort and nervousness, but I suspect it is still less than 120-130 beats per minute. If that is the case and she is otherwise doing well, then I think your daughter is having some common non-heart related chest discomfort. If the heart rate is more like 170-180 (or above), then that is a different story and would require a visit to a cardiologist. Hope that helps.
  25. Jennifer December 22, 22:35
    Hello my daughter is 7 and has been given trileptal 300mg for her mood disorder. She started the medication 30 days ago. The past week or so she has been having uncontrollable little coughs. She can't control it and now she is suffering from pain on the left side of her chest. The other day she woke up crying out in pain, it would hurt for about 5-10 mins then lessen. But would flare up 3 times till it would go away. Any advice would be appreciated. Thank you.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 23, 14:13
      Jennifer: I advise you to discuss this with your daughter's doctor. Coughing spells can certainly lead to chest pain. However, the reason behind these coughing spells should be discussed with your doctor to determine if they are related to the new medication. Hope that helps.
  26. Anjanie Ali December 24, 14:43
    I have a 7 year old daughter and about 2 weeks now she has been complaining about chest pains close to her heart..the pain last for about some seconds to a minute.... What could be the cause?.. Other than she is a healthy child never had any health problems...thanks..
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 30, 12:56
      Hi Anjanie, as you you may have gathered by reading many of the Q&As to this blog, the type of pain your daughter is experiencing is not that uncommon. There are many causes and thankfully the vast majority of them are not related to the heart. Personally, I always feel reassured that the pain is not the heart when it is brief, episodic, random, and not progressive. Of course, that doesn't mean that the pain is not bothersome or unimportant, it just means that the pain is unlikely to be from the heart. More than likely the pain is in the chest wall (musculoskeletal) and will pass with time. If it seems to be getting worse or associates with new symptoms, then a visit to your daughter's pediatrician is a good place to start. Hope that helps.
  27. Maya December 26, 02:44
    My daughter is 16 years old. Since she was 3 years old she has been very active and participated in multiple sports. She has been inactive for a couple years due to a concussion and foot surgery. She has been complaining of really bad chest pains on the left side and difficulty breathing only when she runs or does some type of activity. The pain will lessen after about 10-15 min of rest. We both thought that it was due to inactivity and she just needs to get back into shape, but should I be worried at all? Thank you
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 30, 11:02
      Hi Maya, I would never tell a mom not to worry about their teenage daughter as I am afraid that constant worry is just part of the job ;) However, in regard to the chest pain, this sounds very much like non-heart related pain given your description. While you and your daughter have noticed that the pain is related to activity, which may increase the likelihood of a heart source, your daughter's description to me sounds more like the kind of pain that gets worse with the deep breathing associated with exercise. Next time it happens, ask your daughter if the pain increases as she takes a slow deep breath in - this kind of breath stretches the chest wall from the inside and will worsen pain associated with the muscles/joints of the chest wall. If the pain is not in the chest wall, this breath change will not change the character of the pain. Importantly, and this is a key point for all readers, if the pain is preventing your daughter from being physically active and your worry makes it hard for you to promote more exercise, then check in with your daughter's doctor. Too often kids and parents stop being active because of worry that chest pain is heart related (when it almost never is in youth and young adults), and this reduction in activity only has a negative impact on the child/adolescents long term heart health. It sounds like your daughter wants to be active again, and I would hate it if chest wall pain was the only thing getting in the way. Hope that helps.
  28. Justin December 26, 12:40
    Hi I'm Justin and I'm 18, experiencing a 'quick' stab like pain on my right side of my chest that's been for few months. I have this pain probably More than ones a week. The pain causes me to stop breathing for like a second.. it occurs mostly when I'm relaxed, I'm not ill for while so far... Any Advice would be appreciated..
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 30, 10:59
      Hi Justin, thanks so much for your question. I really appreciate your willingness to ask this question yourself as most of these questions come from parents. Good news: your description of the pain is very typical and almost certainly not heart related. These "quick, sudden, electric" jabs of pain are very common in teenagers and just like yours, these most often occur during periods of rest. While there is not universal agreement about the source of the pain, they are not related to the heart. These episodes will not last forever; most teens report they feel these for about 1-12 months. While uncomfortable, there is little to do other than wait it out. Hope that helps.
  29. Melissa December 27, 14:54
    My 13 year old daughter has recently been complaining of it hurting when she breaths. She is not demonstrating signs of distress, just continuous complaints about it hurting.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author December 30, 10:56
      Hi Melissa, I am assuming that the pain is with deeper breathing, is that correct? If that is the case, it could be same chest muscle pain that many have asked about. However, one other source of chest pain with breathing is asthma, does your daughter have an asthma history? Is the pain more common with common colds or cold weather? Is the pain only during exercise? I might need a little more information to more completely answer your question. However, the source of this kind of pain is so rarely the heart. Hope that helps. For more heart and health related thoughts, follow me on twitter: @MadsenNicolas
  30. Kelly December 31, 21:35
    Hi, my daughter is 17 years old. When she was a baby she had some heart valve murmur or some kind of murmur. Over time it went away and she was fine. Recently she has been complaining of chest pain, shortness of breath, kind of fatigued, and a little dizzy or light headedness when she exercises. She tries to keep exercising but the pain gets so bad that she has to stop. She's going to the doctor in a week, but should we try and see a Cardiologist or does this not sound like a heart related problem? Thank you
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 12, 09:01
      Kelly: I suspect this answer will reach you after you and your daughter have already seen your doctor (sorry). However, I would still like to address your question. Your daughter's history of a murmur as a newborn that goes away over time is quite common and should not be a cause for a concern. Many people perceive a murmur as equivalent with a heart problem, and this is thankfully not the case. A murmur is merely a fancy word for noise. Now occasionally that noise is related to a heart defect or problem, but very often (especially in childhood) it is not. There are several types of relatively common childhood murmurs that we refer to as "innocent murmurs" because they are always in the setting of a normally developed and normally functioning heart. Therefore, I would not associate this part of your daughter's medical history with her current concerns. Given that her symptoms seem to be exclusively with exercise, I am glad you have arranged a visit with her doctor. I hope this helps and hopefully she will soon be on the mend.
  31. Kris January 05, 10:11
    My 5 yr old son has been sick since September. Upper respiratory that turned into pneumonia. After amoxicillin, omnicef, and superax (all 10 day antibiotic treatment) we took him to allergist. Evrry sinus cavity is impacted and we are currently treating that with meds to hopefully prevent surgery. With that being said, in November my son complained of chest pain and couldn't breathe during PE. I figured it was from pneumonia or medications. He still complains of chest hurting, cant breathe and heart jumping when running or playing hard. Should be over pneumonia and all medications have changed. His chest xray showec lungs clear. So I decided to check his heart rate. Resting is 80 on average in 5 days, but when chasing him in the house his heart rate will reach 200 but decreases very quickly. Sometimes his chest will hurt and sometimes not. Is this normal? I can not find a lot if information about kids heart rates while excercising. He has always been very active, but when his PE teacher told me he wasn't thd most active kid, it caught my attention. We have a follow up with allergist soon to see if sinuses have cleared, but in the meantime I am worried about heart rate and chest pain. I have mentioned the chest pain and breathing to his PCP and allergist, but just recently checked his heart rate on my own and havent been back to doctor. Should the heart rate be something I address vety quickly? Any suggestions?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 12, 08:58
      Kris: Thanks for bringing up your question about heart rate, and there is actually a fairly easy to use tool that I think all readers will benefit from moving forward. The peak heart rate that all of us can achieve in normal circumstances is 220 minus age in years (220 - age). Meaning a 5 year boy who is exercising/playing hard can reach a heart rate of 215 and that this is normal (or a 37 year old like myself can reach a heart rate of 183). This equation is meant as a general guideline, and some people may be able to go slightly above or below their age prediction. Therefore, your son's heart rate of 200 should be OK, especially because it returns to baseline so quickly after exertion. With regard to the rest of your question and why he is not as active as previously, I would discuss this with his primary doctor given that he is in the middle of a work-up for allergies. Hope that helps.
  32. Dawn January 05, 12:21
    My 10 year old daughter for the past two nights has complained of chest pain and rapid heartbeat. Each night she has fallen asleep and is awakened by these episodes. I've allowed her to come in my room and rest so I could monitor her and she has grabbed at her chest about every 5-8 minutes before drifting off to sleep again. During daytime she said she feels it a little. She doesn't complain about it or mention it. She engages in all her regular activities without any apparent issue. I have given children's motrin and applied a heating pad to alleviate discomfort. Help!
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 12, 09:00
      Dawn: Chest discomfort that wakes a child from sleep is more unusual. I am especially intrigued by the description of a rapid heart beat. While these episodes could certainly be the result of some bad dreams and some post dream nervousness, it could also be that she is having some palpitations or irregular heart beats (this is less likely to be the reason for the chest discomfort), but probably worth a discussion with your doctor for the reason that it wakes her from sleep. Hope that helps.
  33. Sina January 07, 08:24
    Hello, I just came across your page when I googled sympoms from my 8 year old son. He is a very keen footballer and he has only mentioned recently that his heart hurts when he has a long game. He says then stops for a few seconds and it usually goes away. It doesn't seem to worry him, he actually told me off for worrying as he had this for ages, I tried to specify for how long but he can't really tell, and he's fine. Since then I saw him having these pains a couple of times when not playing football. It seems to be a sharp pain but goes away quite quickly and he's ok then. It is just you keep mentioning to have proper check up if it keeps happening during exercise. Is it something I should be worried about?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 12, 08:56
      Sina: Great question (and thanks for reaching out across the pond - I wonder which EPL team your son roots for? I pull for Tottenham). What can make these types of questions difficult is that heavy breathing associated with exercise "stretches" the chest, and this push and pull of the chest wall muscles can cause pain. This is a common source of pain and obviously does not involve the heart. However, as you have noticed, chest pain with exercise is a screening question for heart related pain because exercise also taxes the heart and may elicit early symptoms. It certainly sounds like your son is quite fit and you did not mention any concerns about a family history of early heart disease, which is reassuring. Generally, the exercise related pain that comes from the heart is not brief and is felt more like a heavy pressure rather than a quick sharp jab. In addition, when the heart is involved there is often a history of loss of consciousness or at least significant dizziness. As such, what your son describes sounds reassuring, but if you continue to worry (or if the pain begins to take on new elements), it is always worth while to discuss this with his doctor. Hope that helps.
  34. Jessica January 07, 16:26
    Hi my daughter is 14 years old and she is have chest pain when she breath and when she bending over it hurts her to the point where she can't go to school please explain what's wrong with her
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 12, 08:55
      Jessica: Sorry to hear that your daughter is having this pain. While I would love to be able to explain exactly "what is wrong with her", as I have mentioned in previous posts, I am limited in my ability to make a precise diagnosis because I am not able to examine your daughter in a clinic. However, what you describe ("chest pain with breathing" and "when she bends over") does not sound like heart related chest pain. In fact, when the pain is related to movement of the chest with breathing, it makes me feel confident that the pain is in the chest wall muscles. If the pain is preventing her school attendance, I would recommend discussing this with your daughter's doctor. Hope that helps.
  35. Emily January 08, 00:43
    Hi, I'm Emily. I'm 18 years old and I honestly am at my wits end. I have really bad chest pains, directly in the center of my chest. It's extremely sudden and comes without cause. Its entirely random, I can either be completely relaxed or sitting up and the pain just "hits me". It causes me to nearly freak out because I feel like I'm not getting a "satisfying" breath and the pains in my chest are so uncomfortable. I tried to tell my mom, but she didn't really worry about it. Especially today, I nearly though a fit in training for my job because I felt like I could barely breath and the pains were nearly unbearable. My nose starts to feel tingly too. I've had panic attacks before, but it never felt like this. I don't have a racing heart rate. These kinds of chest pains have been going on for several months now. The really bad pains happen for over 10 minutes and then it dies down to just feeling uncomfortable, then feeling better. It happened in the middle of the night at 1 am and I woke my parents up complaining about it. I've tried breathing techniques, breathing in steam, stepping into a freezer, anything. Like you said, I have these "Heart Pains". I'm scared and my parents don't really help. What should I do? Should I see a doctor? I'll take any answers and advice. Thank you.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 12, 08:53
      Emily: So sorry to hear about these episodes of chest pain. I can only imagine that this pain must worry you a great deal. Unfortunately, what you describe is not all that uncommon and matches the types of descriptions I often hear about in my clinic. What I often stress to patients and families in situations like yours is that even though the pain is not because of a heart problem, it is certainly very real and sometimes extremely painful. While the reassurance that this type of pain is almost never because of a heart condition can help alleviate the stress associated with the pain, this knowledge does not make the pain go away completely. Thus, if this pain is causing you enough discomfort, or is interrupting your daily life enough, I would suggest discussing it with your doctor. He or she may not have immediate cure for the pain, but I think that at least starting the conversation can be quite valuable. Hope that helps.
  36. Eman January 08, 18:39
    Hi,my 7 years son was having a bad cough for more than a week,his pediatric gave him a 500 ml antibiotic(cefopid)injecton once a day for 3 days.A day after the last shot he started throughing up and complaining of chest pain all the day and he looks pale and doesn't want to eat.what sould i do?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 12, 08:52
      Eman: I would discuss this concern with your child's doctor. I recommend this to everyone reading - any time your child's doctor provides a medication and something happens that causes you to worry about your child's reaction to that medication, this should be discussed. Your doctor wants to know about these concerns.
  37. Pamila January 10, 01:03
    My 16 year old daughter has been complaining of what she believed was heart pain radiating down her left arm and up her neck for the past 8 months. She also gets a headache and feels weak for quite awhile when these episodes occur. It occurs every day at this point, sometimes more than once a day. We took her to a heart specialist and they ruled out a heart disorder, yet we have no idea what is causing her distress and don't particularly know how to help her. We heard that stomach issues often are misinterpreted as heart issues, so we are giving her probiotics and enzymes to help with digestion. We are looking for suggestions to help her because something is definitely hurting her.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 13, 10:29
      Pamila: I can certainly appreciate your frustration (and that of your daughter as well) - 8 months is a terribly long time to suffer with daily symptoms. You did not specifically mention if chest pain was a component of your daughter's symptoms, but I presume it is. I have certainly had many teenage patients in my clinic with chest pain plus arm/neck pain (and bad combination in a 60 year adult), but as you discovered, very rarely a sign of heart problems in a healthy teen. While I am sure you and your daughter felt reassured by the visit with the heart specialist, it obviously did not fix the problem. I can appreciate how difficult that must be and worry myself when I have this type of interaction in clinic and can't provide the family an ultimate answer. In regard to suggestions, you may consider seeing a headache specialist. Migraines can cause all sorts of non-head related symptoms (some kids have cyclic vomiting even without a strong headache), and since the headache is a consistent part of your daughter's description, maybe an evaluations for migraines is in order. You might also consider evaluating any increased signs of stress in your daughter's life – this is NOT to suggest that the symptoms are not real because they very obviously are – it is only to suggest that increased stress can present itself in physical ways. I have had many patients in the past that have benefited from stress management in ways that exceeded their expectations. Hope that helps.
  38. Elissa January 12, 21:15
    2 times in the last 3-4 days, my 7 yr old has complained that the left side of her chest hurts. One time, she was in bed and the other time she was just playing in the house. I listened to her heartbeat both times and it was beating fast for about 30 sec and then beat slower for about 4-5 beats and then back to the faster rate. This happened both times.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 13, 15:29
      Elissa: Difficult to be sure what exactly your 7 yr old is experiencing. Without knowing the actual heart rate, it is difficult for me to discern if the faster rate was the abnormal or normal heart rate or if the slower rate was the normal or abnormal rate. Certainly pain and playing can cause the heart rate to speed up appropriately and then slowly return to normal. In addition, just the act of taking a deep breath can change the heart rate momentarily. I think the key in your daughter's case is that she felt something was unusual given her complaint of chest pain. Unfortunately, at this time, I just don't have enough information to give you proper council. If you are concerned or if these symptoms continue, it is certainly reasonable to have a conversation with her doctor. Sorry to not be of more help.
  39. sharon ashwood January 16, 06:13
    Son aged 9 complaining of pain next to heart this happened when playing football but has also mentioned it a few times when just sitting having had him at doctors examined and said healthy boy seems a bit anxious that something is going to happen to him.im a bit concerned any help please.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 20, 10:31
      Sharon: This sounds like the typical chest pain of childhood. While pain with activity can suggest a heart source to the pain – the typical experience is that when that same pain occurs without activity (sitting as you suggest), this pain is not coming from the heart but rather, it is coming from the muscles of the chest wall. It sounds like you did the smart thing and talked with your doctor. Hope that helps.
  40. Bill January 17, 22:18
    My son is 9-years-old and a very active child. During the 4th game of this basketball season, mid-way through the 2nd quarter he came court side to me complaining that his chest hurt. He had been going pretty hard the entire game. My first guess was that he had pushed a little too hard so I suggested he sit down. He appeared uncomfortable and rested on my lap for about 10 minutes. His skin (arms / legs) got kind of clammy. (He told me later that he had also been having a little trouble breathing). When he started feeling better he went out side for about five more minutes with his mom to get some fresh air. His face became very flushed. But he said he felt much better and we went inside. When the 3rd quarter started he seemed ok and went back in. His face was still a little flushed, but everything was back to normal shortly after and he finished the game. There was no indication that anything was wrong after that and he played a very strong 2nd half. Everything I've read has minimized heart issues in young children. But I have to admit this kind of freaked me out a bit. My gut throughout told me he had just overdone it and his body was telling him to slow down. But I thought it worth getting some advice. Thoughts?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 26, 09:05
      Bill: Sounds like your son loves basketball. I would just keep an eye on him moving forward with his season. If these episodes of chest pain become regular, then you may want to discuss things with his doctor. If he remains free of return episodes, then I suspect that he can just continue doing what he loves. In the meantime, make sure he is hydrating properly before games. Often we focus on in game hydration, but the truth is that pre-game hydration is actually equally, if not more, important. Hope that helps.
  41. Kimberly January 20, 10:30
    Hello.my son is 8 and has been complaining of "chest pain " for 3 weeks now, it does not hurt when he excercises. He has had some acid reflux which he was given meds for. He still says it hurts, not just thd reflux, he says it moves from side to side of his chest cavity and wakes him at night. We have seen a dr and a ultrasound has been ordered. I am concerened of course. Your professional opinion would be greatly appreciated. Thank you.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 26, 09:04
      Kimberly: It sounds like you are on the right track. Non-exercise related chest pain can often be related to reflux. You may want to evaluate if there are any clues in your son’s diet in terms of what type of food might promote more reflux/chest pain. The cardiac ultrasound should help rule out any heart related concerns, but given your brief description, my sense if that the pain does not sound typical of a cardiac source. Hope that helps.
  42. JaQuetta January 20, 22:15
    My 7 her old says today while at school his chest(sternum) began to hurt. It doesn't seem to bother him to much. He plays basket ball for fun but hasn't played today. I asked him all six questions and its been almost 3 weeks since he was sick. I gave him Tylenol to see if that helps. Should I make a doctors appt. Or is it "growing pains".
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 26, 09:05
      JaQuetta: Thanks so much for using some of the tips we provided in the article. It sounds like your son was experiencing some of the normal chest muscle pain of childhood. Hopefully he is doing much better now. I would just keep an eye on him as you are already doing. Hope that helps.
  43. Nicole January 21, 15:23
    My son is 6 and the past few months has been complaining of sudden sharp pain in his chest that stops him in what ever he is doing. It happens when he is resting or active. We had an EKGand echo done. The EKG showed ( what the reading pediatric ccardiologist reported) probable left ventricle hypertrophy, I can see on the EKG print out there is a spike. The echo showed patent foramen ovale, and trace amounts of regurgitation in the tricuspid, mitral and pulmonic valves. We seen a cardiologist and he said he ddoesn't agree with the results and that my son is fine. Im still concerned because he still has pain, and its keeping him from doing things that he used to love. Thank you!
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 26, 09:06
      Nicole: It sounds like your son has had a thorough evaluation with the pediatric cardiologist. All the findings you report on the ECHO are actually fairly typical in the general population. In addition, left ventricular hypertrophy by EKG is often a false positive, which is the case with your son as the ECHO did not reveal the left ventricle to be thickened. I would re-explore the non-heart related sources of chest pain with your son’s primary doctor. It sounds like the pain is interfering in his life, so getting to the bottom of the problem would obviously be great. Hope that helps.
  44. Sharmee Ligugiud January 24, 11:25
    Hi my 13 year old daughter has been saying she has chest pain like crushing on her left side and she says sometimes she cant breath and i didn't pay attention to it but then i saw her squeezing her chest on the left side should i give her medical attention immediatly? Because her chest pain only lasted for a minute and her breathing is very fast until its back to normal. What should I do?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 26, 14:15
      Sharmee: Your daughter's description of the pain and her age is quite typical of the non-cardiac chest pain of adolescence. The chest pain of the muscles in the chest can be quite painful and often made worse by taking full breaths. Thankfully, in most cases, like your daughter, the pain is quite brief and returns to normal without intervention. While my words may offer you some reassurance, let me also say that if you are worried about the pain, then a visit to her doctor is probably helpful just for peace of mind. Hope that helps.
  45. candice January 25, 21:35
    My 5 year old son has came to me and said his heart hurts 3 times with in the past week. He's been very tired after school more then normal. I checked his pulse which is 100. He was sick a little over a week ago... he hasn't been injured. He said it's mild pain. Only last 5 mins... and he said he does get mad at school because some classmates are mean to him all day... It only hurts him around night time... ANY SUGGESTIONS?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 26, 14:14
      Candice: It is interesting how often the phrase that our kids use to describe their chest pain is that their "heart is hurting". This description can be unsettling for sure. Thankfully, as you have read in this blog, the heart is almost never the cause of chest pain in children. Sounds like your little one has had the same community illnesses that my kids have had. Since the pain is mild and brief, my expectation is that this pain will resolve in the near term. However, if it is getting more common or lasting longer, then a visit to his doctor is the best move. Plus, that doctor visit may be a good time to explore if your son is having any trouble with bullying at school. Hope that helps.
  46. Raquel G January 27, 01:35
    Hi, my son is 13 and has been a swimmer for almost 4 years. Recently he told me that after he swims for while or even if he runs hard in PE that his chest hurts on the right side by his ribs and shoots back to his shoulder on the right side as well. He has had a cold/cough that has lingered for 7 weeks now but he says that it happened before he had his cold too. His grandma has hypertrophic cardiomyopathy and he was tested when he was 7 for it and it was negative. I was told that this can develop in adolescence. Would it be advisable to have it checked?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 27, 13:57
      Raquel: Thank you for your question. The key feature in my mind from your question relates to the family history of hypertrophic cardiomyopathy. When you say that he was tested, do you mean genetic testing because grandma's genetic type was known or do you mean that he received an ECHO (heart ultrasound). Also important in your question is whether grandma's child (either you or your husband) has been tested – this is important because being a first degree relative makes a difference. Therefore, here is what I suggest, try to learn grandma's genetic type of hypertrophic cardiomyopathy as this will allow for everyone else to be screened more definitively. If that is not possible, then first degree relatives should be checked by ECHO, and likely your son as well given the symptoms. In the absence of genetic testing, an ECHO screen needs to be repeated on a regular basis (every ~5 years) for first degree relatives because (as you state) things change over time and what was once normal may no longer be that way. Hope that helps.
  47. Megan January 27, 10:33
    Hello! About a week ago our 6 year old son walked up the stairs and said his heart was beating really hard and fast. He is a very active kid, so walking up the stairs shouldn't cause a significant increase in HR....I wouldn't think. I put my hand on his chest and it was beating really hard. He reports that this happens sometimes and notices it most when he is sitting still. He states that it hurts when it happens, not that it just feels weird. It happened again this morning after playing with his brother not very vigorously. He didn't c/o it hurting that time but I put my hand on his chest and his heart was beating very hard. I have taken his resting HR several times and seems to be WNL (78-82bpm). I have not been able to take a HR when he is c/o the pounding, fast, pain though. The pain he c/o is not something that makes him cry or stop what he is doing. Sometimes when I take his pulse it seems like the beats are not always evenly spaced, but not sure if that is just a mom worried thinking she is feeling something. Any thoughts would be greatly appreciated! Thank you in advance!
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 28, 16:23
      Megan: Thanks for the question. It is hard for me to be definite given the nature of your question, but here is what I think. Active kids have strong heart that are very close to their chest wall, and when the heart speeds up normally, it can certainly feel like an impressively hard and fast pounding. At your son's age, an appropriate heart rate of 200 beats per minute is not abnormal and can be quickly achieved with activity. However, you also made mention that your son reports this sensation when he is resting, and that is a little more curious. His rate should be more in the 80-110 range with rest, and if it is up in the high 100s (160 beat per min or more), then I think a little more evaluation may be prudent. Since he is well, this does not sound like an emergency, but if it continues (especially during rest) then I would recommend talking to his doctor about it. It is most likely to be just normal heart rate variability but as I often say, don't ignore that mother's intuition – you have it for a reason. Hope that helps.
      • Megan Fantozzi January 28, 17:05
        Thak you so much for taking the time to reply. I really appreciate it. Is there any reason I should be concerned with the irregularity in his pulse. It seems as if it beats normal for several beats, then beats slower for several beats. I have an appointment with his pediatrician at the end of the month, and because it seems like forever away, I want to be sure it isnt something I should be seeking more imediate care for. Thank you again for taking time to respond, and for your help.
        • Dr. Nicolas Madsen
          Dr. Nicolas Madsen Author January 30, 09:41
          Megan: A little like your previous question, it is hard for me to be certain because there are some subtle aspects to your question that are hard to sort out in this format. However, with that in mind, what I can tell you is that everyone's heart rate changes with their breathing pattern. This phenomenon occurs because breathing in and out changes the amount to blood flow returning to the heart – it is called sinus arrhythmia and it is totally normal. Some kids have an impressive change in heart rate with breathing that can be quite noticeable. This may be what you are appreciating with your son since you seem to describe more a rhythm of a few faster beats and then a few slower beats with a repeating cycle. Given your concern, I think a conversation with his doctor makes sense. Hope that helps.
  48. Raquel January 27, 15:19
    Thank you for your reply. My son had an ECHO and my husband was checked (she is his mom) and he was good. Do the symptoms I described earlier sound like its related?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 28, 16:22
      Raquel: The symptoms you describe could or could not be related. If this was a matter of pure probability then one would suspect that the chest symptoms were not related as those types of symptoms are common in the teenage population regardless of family history. However, given what you have told me so far, your husband and potentially your son have not be adequately ruled out for possible hypertrophic cardiomyopathy. In the absence of genetic information, then a visit to the cardiologist with ECHO should be a regular part of their care at a regular interval. Given that your son has been more than 5 years since his last ECHO, and that he is having exercise induced chest pain, I would advise you to arrange for a visit with a pediatric cardiologist (if possible, with a center with expertise in Cardiomyopathy). This recommendation is also true for your husband. Hope that helps.
  49. M January 29, 10:40
    A few nights ago my 13 year old daughter and I were working out. She is overweight at 5'2 140 lbs. She does not excercise at all (except for in school) and I want to break her out of watching TV, video games etc.She has never been the active type, Never goes outside. The other night, After about half hour of cardio ab exercises she complained that she had a squeezing pain in her chest and had trouble breathing. I am asthmatic- she is not. I told her to stop and take a break but she insisted that she was okay and wanted to keep going. After another 10 mins I noticed she was struggling through and made her stop. After drinking some water and a warm shower she said she felt better. The next day she said she was fine but just had pain in her collarbone. She also had to sit out of excercise at gym in school about two months ago because of chest pain. She had a check up a few months ago and it seems all was fine. Could it be because of her super sedentary lifestyle and it's too sudden for her to excercise vigorously? -Worried Mom
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 30, 09:41
      Worried Mom: I think you and your daughter have it correct. This sounds very much like the common chest pain of childhood and even though it has happened with exercise, I think you explain the most likely reason well. Now if she has any events of passing out with exercise or the symptoms seem to get progressively worse, then maybe a return trip to her doctor makes sense. However, until then, help encourage her activity as being sedentary and overweight (as you know) is certain to lead to long term heart related troubles. Just make the activity increase slow and steady and her her find activities that she likes. Hope that helps.
  50. Natalie Stephan January 29, 12:29
    Hello Doctor, My name is Natalie, I am 18 years old and for the past few months I have had sharp instances of pain in my chest, usually after exercise. For a while I thought it was because I was trying to get back into shape. Now that I have been exercising regularly I still get these sharp pains. They only last for a second or two, only about once a week. I still am concerned that it has something to do with my heart and that I should go see a doctor. Do you know what I causing this?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author January 30, 09:41
      Natalie: I can't be certain what is causing your pain without the advantage of the physical exam (and the limited nature of this interaction). However, what I can tell you is that brief, stabbing chest pain episodes at your age are related to the heart less than 1% of the time. It sounds like you have made strides to get more active, which is wonderful and you should be proud of yourself. Of course, if something is really bothering you, a conversation with your doctor is always a good idea, but I doubt very much that the pain you describe is related to your heart in any way. Hope that helps.