Chest Pain in Children: 6 Questions for Parents to Ask

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 be 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.

Read about potential ways to help your child find relief from chest pain in this related blog post.

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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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Comments

  1. Lisa February 01, 03:17
    Informative article. Thank you. My 14 year old son has had chest pains for months. His pediatrician indicated maybe pleurisy. In addition, he feels that when he jumps something is loose and moving inside his chest and abdomen. He also has palpitations and last night I could hear it from a foot away (literally) - a sloshing and clicking sound. It was gone in a few minutes. He is sick with a flu like virus now, but this has been going on for months.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author February 03, 07:52
      Lisa: Thank you for the positive feedback. It sounds like your son is bothered quite a bit by his symptoms (chest pain, feeling of something loose and moving, and palpitations). Certainly being sick with the flu can make a lot of things feel worse, although in your son's case it sounds like his symptoms having been present longer than the flu. Maybe I am reading too much between the lines, but it seems like your plan currently is to watch him closely and see if things improve on their own, which I think sounds reasonable. However, if he remains burdened by his symptoms, or he begins to feel worse with an increased duration of symptoms, then a return visit to his doctor may be helpful. Hope that helps.
  2. Veronica February 04, 17:03
    My 15 year old son just called me complaining of a sharp pain where he feels his heart hurts it is a pain he never felt before. It is a constant pain that has not gone away. He was sick a few weeks ago with a really bad cold and it seems as if he is getting sick again with the cold. His throat is soar and he is coughing too. Not sure what to do other than keeping a close eye on him and see if the pain continues, if it does than take him in to looked at. Pain in the chest just scream alarm but I am not sure. I hope someone can help!
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author February 06, 08:28
      Veronica: Chest pain in the setting of an illness is actually quite common in kids and teens. I think your idea is perfect – keep a close eye on him and if the pain continues or he begins to feel worse, then take him to the doctor to have him checked out. Typically chest pain with a bad cold and cough is simply from pain in the chest muscles that are being taxed by the constant coughing. However, if the pain is constant and if the chest pain is made worse by lying flat on his back, then you should have him seen for concern of pericarditis (see discussion in the blog post above). Hope that helps.
  3. Marcie February 06, 10:59
    I have an 11 year old that has started complaining of chest pain for a little over 2 months. The pain comes and goes quickly lasting a minute or less. It also does not strike in the same spot usually above either breast bone.He has had it twice towards the center of left breast bone. It has always stricken during down time sitting in class or just at home. Last night it happened on our drive home after 50 minute karate class about 15 minutes into our drive. I am one of those worry some moms. He has been to the cardiologist and EKG was normal and so was his chest ultrasound (dont know if thats what its called). Our doctor gave us a monitor for 1 month to record episodes and out of the 5 we have so far everything looks normal. Im looking for some insight with your experience of what might be causing this. Or a suggestion of any further test. He is very active 95 pounds. No passing out or sweating no temperature during episodes. Heart rate high 90's when it occurs. Thanks in advance.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author February 09, 08:50
      Marcie: It sounds like your son has non-heart related chest pain, which, as you are discovering, is quite common and quite bothersome. Your son has had a full cardiology evaluation and it did not uncover any problems, which is wonderful. As you might have read, there are several possible sources to his pain, but you can feel confident that his heart is not one of them given the evaluation he has had previously. Hope that helps.
  4. Michelle February 06, 22:01
    My 14yo son has complained about chest pain while training for,and playing, basketball and on one occasion after a bike ride. Today during his game he had pain, his face was white and afterwards, though he felt better, his face was blotchy, very red around his eyes and still white in patches. He also on occasion has mentioned feeling dizzy. I am planning to take him to see our gp next week. Should I take him sooner? Michelle
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author February 09, 16:17
      Michelle: I think a visit to your gp next week makes sense. In the meantime, it would probably be best for your son to do his best to limit the severity of his training. Since his symptoms are only with exertion, it is better to be mindful of that in his case and limit the degree of his exercise. However, the likelihood remains that in the majority of case, even this type of chest pain is not secondary to the heart (but fully agree with a thorough evaluation by his doctor). Hope that helps.
  5. Roshni February 07, 05:58
    My son is 4 years old. He keeps complaining about his heart pain. It happens after eating his food and at times even before eating . Is it a chest burn or some thing else. I showed him to a pedestrian. The doc says it's just chest burn. I am confused because it's happening for past 5 to six months..
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author February 09, 16:18
      Roshni: Given the age and your description, I doubt this pain is related to your son's heart. However, the duration is a little concerning and likely warrants a little more evaluation for the source. It certain sounds like some sort of reflux type pain, but obviously it is not possible for me to be sure with a thorough exam in person. I guess I would suggest your explore the possible reasons a little more with his doctor. Hope that helps.
  6. mirium February 08, 07:03
    Hi, My 6 year old girl, is complaining that her "heart hurts". She seems to be happy and active, but comes back every 40 mins complaining again. I dont want to just assume its muscular and it actually be something bigger. Please advise Regards Mirium
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author February 09, 16:18
      Mirium: I agree, when our children use phrases like my "heart hurts", it is hard not to worry about something bigger. Thankfully, the heart is very rarely the source of chest pain in an otherwise healthy child. While the pain is real and located in her chest, it is much more likely to be muscular in nature. Of course, if you continue to have a bad sense that something else is the matter, then a visit to her doctor may offer some reassurance. My first thought is whether your child has exercise induced asthma type symptoms (just a thought, not a diagnosis since I am not formally evaluating your daughter). Hope that helps.
  7. Nicole February 08, 19:54
    My daughter will be 8 in one week. She had a cold several weeks ago but got through it fairly quickly and since then occasionally complains of chest pain. It is often accompanied by stomach pain. When we've walked the family dog she does fine unless we go fast (very light jog), then complains of chest pain again. Today we went shopping with my mom, she had stomach pain that went away after using the restroom, and then she had a big lunch and within about 30 minutes was complaining of stomach, chest and jaw pain. I was taking her to urgent care but buy the time we got to the parking lot she said it was just her stomach, not her chest or jaw anymore so we left, and then later she said it hurt a little again. As of right now I plan to watch her very closely and try to get her in to see our pediatrician this week and go from there.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author February 09, 16:19
      Nicole: It sounds like you are on the right track. Those pesky winter colds can have some residual effects, including pain in the chest. It sounds like your daughter is otherwise well, and I would trust her to be able to tell you how she is doing (since she is nearly 8). I am sure her doctor will be able to help you sort out some of her symptoms. Hope that helps.
  8. Sarah Gavaghan February 09, 22:16
    My son is 6 and half average height and weight and normally very active. He has had no illnesses, not even any colds and is very healthy. He had be complaining of pain in his heart after exercise (running, karate ttrampolining etc) he says it feels like his heart is going to explode and he has to stop the activity to stop the pain He has been to his paedratucian who did an ecg which was normal and she also referred for a chest x Ray also normal. She has done a referral for a cardiologist but we can't be seen for 5 weeks and I am worried as he is now complaining when just walking. I already took him to the ER has he had it happen at school playing tag and was in aginy so went to the school nurse. No one (dr or insurance) seems to be treating it urgently despite my numerous calls/visits expressing my concern. They way I see it a normally active ) year old is struggling during physical activity and this doesn't seem normal to me! Thanks Sarah
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author February 12, 08:20
      Sarah: Sorry to hear that amid your worry about your son, you have not yet been able to see the specialist your pediatrician recommended. Unfortunately, without your son's actual data, I am afraid that I am not able to provide you with any definitive thoughts today. However, what I can comment on is that I think the referral to the cardiologist is a good idea. By any chance, have you tried to count your son's pulse (heart rate) during one of these episodes? It will be elevated because he is in pain and recently exercising, but I wonder how elevated it might be. If you attempt to count his heart rate, I advise that you practice a few times while he is resting first (it can be a little tricky). A 6 year old should have a resting pulse in the low 100s, and during vigorous activity, the heart can climb to 200. But if his heart rate is approaching 200 after activity (more than 5 minutes) during one of these episodes, that is curious and would be a clue that his cardiologist could use to guide his care. Hope that helps.
  9. Janvi February 10, 01:46
    My daughter is 10 years old and she had ear infection first and doctor gave antibiotics. By taking antibiotics she got chest pain and again doctor gave high dose of pain killer still she has chest pain and heart pain from 2 weeks, her pediatric said its acidity and constipation and gave her constipation powder but pain is still same. Is the pain is because of acidity and constipation or she has something else problem. Iam really worried for her and can't see her in pain.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author February 12, 08:21
      Janvi: Acid reflux is certainly a common cause of chest pain in children - many many more times more common than heart problems. It is true that antibiotics can upset one's stomach and cause some acid reflux. I would give it a little more time to see if the chest pain symptoms resolve as I assume she has finished her antibiotic regimen. You may consider discussing with her doctor the benefits of acid reflux medications that can be taken as needed. Hope that helps.
  10. Roxanne Hevelone February 10, 04:03
    My son is 11 and is a very stout young man.He is active and is able to lift and carry nearly 100 pounds as well as very broad shouldered and barrel chested. He has been complaining of right sided chest pain for a week or so. We've taken him to the chiropractor and had him adjusted and he has indicated chostochondritis. I've been giving ibuprofen and heat packs for the discomfort. It has not been activity based pain as it seems worse in the evening as he is quiet. The pain seems to be more intense today than it has been with making it difficult to get comfortable enough to sleep or even breath deeply. I do know that they have been doing intense exercise in their physical education class and question this being some of the issue. Wondering if chostochondritis vs. Pluresey or something else? Please help!!
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author February 12, 08:22
      Roxanne: It suspect that the chiropractor is on the right track. Unfortunately, chostochondritis can be very painful and can last a while. I would recommend to your son to rest a few days to allow some of the acute flare to subside (if he continues in the short term with vigorous activity, it will only intensify the problem). A few days of rest should go a long way to helping him recover more quickly. However, if the pain continues to worsen, and if you notice that it is worse while lying flat on his back as opposed to sitting up (or leaning forward), then I would recommend a visit to the doctor to ensure that this is not pericarditis (although given that these symptoms are more than a week old, pericarditis is not very likely as the pain in these cases usually intensifies in just a few days). Hopefully rest and ibuprofen will have your son back to normal activities in the near future.
  11. Gail February 11, 14:02
    My 14 year old grandaughter while playing on basketball team had 2 events occur at 2 games. While playing ,had to come out of game very pale , co squeezing in her chest and inability to breathe. Breaths were very shallow. She rested for a 15 min period went back into the game but lasted only seconds. Complained of heart hurting. Pain in chest center. 2 nd event even worse than first. No complaint prior to game or ever. Fine since. As stated she got very pale . SHe has appt. next week with dr. Should I be concerned. She is in my care.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author February 13, 13:42
      Gail: I think you are right to take her to the doctor given the specific exercise related symptoms. Amazingly, the probability is still that the pain is not from her heart, but with her symptoms, I agree with your decision to have her properly evaluated. In the meantime, I would rest her from any competitive sporting events. Hope that helps.
  12. Angela February 21, 20:41
    My 14 yr old son has Addison's Disease, and MEN, and araynauds. For the past two weeks he has been complaining of an "odd pressure" in his chest. I asked him if it felt like trapped gas (he's had that before). He said "no. It feels like something is trying to come out of my chest, and I can't breathe well." He is permanently on lower levels of prednisone for his Addison's, so his immune system is very weak, and he pretty much catches everything. Does this sound like something I should address with his pediatrician, or his endocrinologist, or both?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author February 24, 08:10
      Angela: I would start with the pediatrician (although he or she may choose to involve the endocrinologist). Your question brings up a good point – the simple points/questions of the attached blog are primarily intended for children who have the good fortune to be without a complex medical history. While those children, like your son, with more involved medical needs may have typical teenage medical symptoms such as chest pain, they are also vulnerable to more unusual presentations which should not be ignored. This is not to suggest that your son has anything immediately worrisome. I just want to remind the readers of the this blog that the chest pain questions are primarily intended for kids with a "typical" medical history. Hope that helps and thank you for your question.
  13. robyn addison February 22, 17:18
    10yr daughter, complains of having "kiddy heart attack" when she is in active play from dance game on Wii, to limbo at church. I heard this a couple times in last 6 months, but apparently had this in public school last year. She is homeschool now and is very tired about 1 hour after eating and needs a nap, complains of stomach aches almost daily at different times of day. She is not on any meds. Last week she chose not to do something for fear her chest would hurt. We have no insurance or pediatrician. She is up to date on shots, and has not had Streep throat since being out of school. (3 x a year in school). Could I just call a local pediatric cardiology office to save $$$ on a pediatrician visit, or should I find one. I understand the less than 1 percent heart issues. Husband thinks it will pass. But what about the 1 percent, are we stressing her heart. No stress now she is home very relax and happy. Home from.school since Aug 2014
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author February 24, 08:09
      Robyn: Thank you for your question. While I completely understand the financial stress of clinic appointments (and truly wish that we had a medical system in which money did not dictate care choices), I really think you are best starting with the pediatrician. There are so many more common reasons, other than the heart, to have symptoms like your daughter's and the pediatrician would be the best place to address those other reasons. A visit to the cardiologist would be more expensive and unlikely to help as much. I would advise you to ask around your neighborhood for recommendations for a great pediatrician. Hope that helps.
  14. Filippa February 23, 04:19
    Hello, my name is Filippa and I will be turning sixteen this year (born 1999). I have been experiencing a Very sharp pain in my chest both on the left and right side but its more common on the left side. Before having chest pains I didn't do any activity, actually there's been several times where I've woke up and then had chest pains, also when I go to bed while laying still. I haven't been sick recently but I've had a headache for a long time. The chest pains come and go, sometimes months between. The chest pains have been going on since 2014. The pain definitely increased when I tried to sit up in my bed and if I would've rate it, it would have been a sharp 7-9/10. These chest pains only last for a couple of seconds sometimes longer then earlier, but I dont feel any tenderness around the area. I feel very uncomfortable with these chest pains and haven't told my parents yet but I know my brother have experienced the same thing. I can never predict these chest pains or feel them coming. Also, I don't feel any kind of stress, although I'm stressed very often. When I experience these chest pains it sometimes makes it hard to breathe and I don't know what to do to stop them, I've tried not moving but that doesn't work either and when I tried to sit up it hurt even more. In general I would say the pain often is severe.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author February 24, 08:07
      Filippa: Thanks for your question. First piece of advice, tell your parents that you are feeling these chest pain episodes. Second, tell them that chest pain in teenagers like you describe is common (so common in fact that your brother has the same thing). As you know from reading this blog, non-activity related, brief, sharp chest pain episodes is extremely unlikely to be related to the heart. While these episodes are very painful and frustrating, they are almost never related to the heart. This should pass with time. However, in the mean time, tell your parents. They want to know if something is bothering you. Hope that helps.
  15. Jen February 23, 14:06
    My 14 year-old daughter has been complaining of a feeling of "pressure" right above her chest. It comes and goes and she rates the pain about a #5 on a pain scale of 1-10. She has UC and about 2 weeks ago she went off of her daily meds (Lialda) for good. She had this same symptom (chest pressure) when she was going off of prednisone but then it went away. Do you think it could just be growing pains? Or do you think it has something to do with her UC/going off her meds? She is in excellent health, otherwise. Her inflammation numbers (in her blood and stool) were just tested in December and they were great! Any advice would be really appreciated! Thanks a million Dr. Madsen.......so glad you went to med school:)lol!
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author February 24, 13:46
      Jen: Glad to hear that your daughter's UC is under good control. While I am certainly not an expert in GI related disease, and as such, I can't speak to some of the effects of coming on or off her UC meds, I haven't heard of chest pain as a common symptom of changing medications. More likely, your daughter is having normal non-heart related chest pain of adolescence in addition to her UC. If the symptoms remain as you describe, you may be able to give it some time to see if the pain passes on its own. However, if the pain worsens or seems not to improve, then this would be a good thing to discuss with her PMD and GI team. Hope that helps.
      • Jen February 25, 05:44
        Thanks Dr. Madsen! This helps ALOT!!!
  16. Robyn Addison February 24, 10:27
    Thank you for responding
  17. Beth February 25, 09:33
    Hello! My son is 7 years olds and has had a fetal Echo and was checked out 2 times after birth and was cleared by the cardiologist. His 15 year old sister has HLHS so we were very cautious. He is currently on day 6 of amoxicillin for strep. At his appointment a new nurse practitioner mentioned he had a loud murmur which I was aware that he does have one. This morning he started complaining that his heart was hurting. I felt his chest and it seemed to be beating hard and fast. I counted 108 beats per minute. He then complained the right side of his chest hurt. After some time reassuring him that he was ok and distracting him, his heart rate went down to 92. Is there any delayed heart defects unseen during infancy or arrhythmia problems I should be concerned about? I have worried so much for my children that I don't want to freak out.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 03, 08:41
      Beth: First off, I hope your 15 year old daughter with a history of HLHS (Hypoplatic Left Heart Syndrome for those not familiar) is enjoying good health – and given that history, I don't blame you for being quick to worry about your son's heart health. As I am sure you know, there are not any congenital heart structural defects that could develop over time as these are by definition present at birth (some may only yield symptoms years after birth, but all are present at birth and would be seen by heart ultrasounds). In addition, if there was some structural defect present that was previously undiscovered, it would not show up with symptoms of pain (rather, symptoms would be fainting, fatigue, and shortness of breath, along with signs such as high BP). Now your question about arrhythmia – that does typically show up later in life but typically the sensation is not pain but descriptions such as "fluttering", "skipping beats", or "hiccups" in the chest. In fact, your diligence to count the heart rate is very reassuring as 108 bpm is not that fast for a 7 year old (especially when pain is involved). I am guessing that the current illness is giving your son some associated chest pain and that this will pass. Of course, if it does not or if it gets worse, then you might feel better with a check up with his pediatrician. Certainly if the pain becomes constant then I would take him to the doctor to make sure the strep infection is not causing any other issues. Hope that helps.
  18. J February 25, 14:02
    Hi, my brother is 13 years old with IBS and a bit overweight. He has a tendency to stress himself out over literally everything and get aggressive. He has been complaining about chest pains ( they occur in the middle of his chest 99% of the time) when he does get stressed and they tend to be really uncomfortable for him, his IBS also plays up when stressed which doesnt really help either. One night his pains were so severe that he was actually screaming and crying, however he had a bad cold at the time. We took him to the doctor several weeks ago and he checked his heart beat and such and said he didnt think anything bad of it. What I am asking is whether we should be concerned over these pains or are they harmless?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 03, 08:40
      J: Thank you for your question – it sounds like you are a fantastic advocate for your brother, which is very cool in my book. Regarding your brother's chest pain episodes, they certainly sound a lot like the typical non-heart related chest pains of many teenagers. As you mention, stress can be a significant trigger for pain, and it sounds like that is at least some of the concern for your brother. I am glad your brother was evaluated by his doctor and I would trust that he/she was able to rule out a lot of the worrisome problems during that clinic evaluation. You may want to think about different therapies to help your brother manage stress (if you have not already). Hope that helps.
  19. Sam February 28, 03:03
    Hi, my name is Sam and I am 16 years old. I have been experiencing chest pains in the left side of my chest. Often they're in different places buy this has been occurring for around 3 months now. I get the pains pretty much everyday throughout the day but most of the time I could ignore the pain but on the odd occasion the pain tends to be quite painful. I am seeing a doctor about it and they've said it's probably not something to do with your heart. Thankyou.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 03, 08:42
      Sam: I agree with your doctor. Your description is classic for non-heart related chest pain of adolescence. Now that doesn't mean the pain is not real because I have known many teenagers who tell me how painful these episodes can be. Just know that this will pass with a little time. Hope that helps and thanks.
  20. arlana odden March 02, 14:27
    My 11 year old daughter complains of sudden chest pain while doing strenuous activities. This has gone on off/on for 6 months. When we visited her doctor, he called the condition Costochondritis. Read upon it, but still months later she still has pain when doing anything strenuous. I'm concerned about this being something that was missed as an infant. I was told she had a heart murmur at birth, but that it would close. What are your thought on this issue. A child just had a heart attack at her school while playing soccer, and was later said to have had anomalous let coronary artery. I just don't want to see the same for my child.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 03, 13:01
      Arlana: You bring up many good points. The importance of the murmur as an infant is a common question, but thankfully these murmurs are typically innocent and not associated with a heart condition (which sounds like the case with your daughter). Your daughter's pain being 100% association with exercise does raise an eyebrow of suspicion, which is why I imagine you had her evaluated (which sounds like resulted in the common diagnosis of costochondritis). However, all of this is in the setting of the terrible event you describe which happened at your daughter's school, and which sends fear down the spine of every parent. What I would say is that 6 months is not an unusual amount of time for a pre-teen to experience chest pain. In fact, in some ways the experience of chest pain for that long without any other worrisome symptoms is reassuring that the heart is not the culprit (if the heart is the source, typically over that time course new symptoms would emerge). Yet the relationship with exercise alone can be difficult to ignore despite the fact that usually the pain is from the deep breathing of exercise and the associated big movements of the chest wall. Therefore, if you continue to worry (and certainly if new symptoms appear), I would restart the conversation with your doctor and maybe discuss the utility of a consultation with a pediatric cardiologist. Peace of mind is certainly worth a lot. Hope that helps.
  21. Sam March 03, 12:56
    Hello, Sam again, I recently had an ECG (3 weeks ago) and the results came back. My doctor says everything looks fine but there was something unusual in the pattern that shows and suggests that my left side of my heart could be bigger than my right side. She still thinks it's nothing to do with my heart but is asking a cardiologist for further advice. Should there be anything to worry about? Because what if that is the reason I am getting pains?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 10, 09:19
      Sam: I would sit tight until you and your doctor hear from the cardiologist. Some times the EKG can suggest a concern, but upon further review from a cardiologist, this area of concern can be determined to not be an actual abnormality. Best probably to wait and see before speculating any further. Hope that helps.
  22. Emily March 07, 07:05
    Hi Dr. Madsen. I appreciate this blog and the 6 questions to ask my child about his chest pain - thank you for this information. My 7 year old son is complaining of chest pain (in the center of his chest)for 3 days now. Overnight it has caused him to wake up twice and this last time it is consistent pain. No fever, recently did have a cold and ear infection. He is overweight and in my mind I downplay it because as you state most chest pain is not heart related. However, this consistent pain and his visible discomfort has me concerned now. Am I justified in this concern and should I take him to the pediatrician or assume this will pass? The pain is there with or without exertion and he has told me he doesn't want to laugh or play because it makes it harder for him to breath.... Thank you! A concerned mother.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 10, 09:20
      Emily: Persistent chest pain is a different category than the usual chest pain of childhood (which is typically episodic with brief periods of discomfort). If your son truly is in continuous discomfort, I would want to make sure to rule out pericarditis. Pericarditis will present with pain essentially around the clock, although it can vary from mild to moderate to severe throughout the day. Pericarditis pain is especially sensitive to the position of the body – lying down makes the pain most intense. If this sounds like your son, I would encourage you to have him seen today by his pediatrician to get to an accurate diagnosis. Hope that helps.
  23. Megan March 10, 09:13
    Hi, My daughter is 8 1/2 and we have recently started running. The last 3 days, we've walked 4 minutes and run 1 minute. Each time we've run in these 3 days, in less than a minute she stops and complains her chest stings as she points to the middle of her Sternum. So we end up just walking. Last night I could see it in her face it didn't feel well. I asked if she could breath okay and she said yes. I asked if it hurt any other time and she said when she is in gym. Any ideas?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 11, 09:37
      Megan: I would like to start by congratulating you and your daughter on starting an exercise program. There are very few things we can do as parents more important than encouraging activity in our children. You are giving your daughter the gift of healthy habits, and that will benefit her forever. In terms of your question, her symptoms sound typical for kids her age. I assume that she has never had these symptoms with previous activity and I assume that she does not have a family history of early (less than age 40) heart disease. I think you have 2 options: 1) you can gradually increase the activity and evaluate her discomfort, or 2) you can discuss this exercise plan and symptoms with her regular doctor. Both options have merit and the choice is largely based on how she appears to you. Hope that helps.
  24. Concerned mom March 11, 01:18
    My 15 year old son for months now has been getting a sharp pain in the center of his chest.He could just be sitting or walking through the house & out of no where comes the sharp pain in his chest.Mostly center that makes him grab it & kneel over.It lasts for seconds to 5 minutes at a time.Hes average active & otherwise healthy.He says it doesn't hurt to breathe in but I'm making him an appointment tomorrow morning since he just had another episode.About 1-2 a day.Also he wakes up during the night with severe Charlie horse pains in his legs.The Dr recommended Gatorade & bananas for that.Could this be connected?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 11, 13:13
      Concerned Mom: It sounds like your son is having some of the typical non-heart related chest pain of adolescence. The features that make me think that are the "sharp nature", the episodes are brief and occur at random times, and there are not a lot of other associated symptoms. And just to be clear, the fact that the heart is not involved does not diminish the fact that these episodes really hurt. Hopefully the visit with his doctor will help give you and him some peace of mind. Hope that helps.
  25. Erin March 12, 14:19
    I am a 15 year old girl, i often have hert and lung pain but im not sure why its just at random times not after food or sitting or anything. I am really worried what it could be. Please help.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 16, 13:38
      Erin: Thanks for your question. The first thing I would do is mention this pain to your parents to make sure they are aware that something is bothering you. Random chest pain is very common in your age group and is thankfully rarely something medically serious. However, it sounds like you are worried, and therefore, maybe talking to your doctor after talking to your parents is a good idea. Hope that helps.
  26. Alena March 14, 22:20
    I have 11 years old daughter. She began to cough in November 2014, it is 4 months now. We saw asthma specialist, lung specialist, pediatrician, children hospital.... She got coug syrups, antibiotics, steroids, inhalers."...she still cough. She has mild scoliosis at her chest area. We see chiropractor, but she also complains of sharp poking pain on left side under breast, and can't breath out. Poking is also sudden, last few seconds.sometimes it moves to right side. I am so worried, and desperate for an answer. Not sure doctors know what is going on. She also has low level of vitamin D, she started suplement. Question is why coughing deep, dry, Barky cough for 4 months,no medicine helped, and why sharp poking pain.? Any advice will be appreciated. We are taking her to children's lung specialist in a week.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 16, 13:37
      Alena: So sorry to hear about your daughter's cough. I am glad to hear that you are going to a a pediatric lung specialist. 4 months is a long time to have a chronic cough and hopefully this specialist will be able to figure out the root cause. The list of possible causes is actually quite long and without access to her medical record, I am afraid that any suggestions from me would just be guesses at this point. However, the pediatric lung specialist should be able to help. That is certainly who I would turn to in your situation. Best of luck.
  27. Toni March 16, 20:47
    I have an 11 year old daughter that has been complaining of sternum pain for several months. She describes the pain as dull, sore, and pressure-like. The pain is on each side of the sternum and very tender to the touch. It is pretty much always present, however, she notices it more while not active. She is in many school sports and never complains upon activity. She actually gets relief from this pressure when taking a deep breath. She has had an x-ray which was clear. Her pediatrician has referred her to physical therapy and she had evaluation today. PT said he did not know but prescribed a few exercises since it appears to be related to musculoskeletal pain. She had full cardiac work up approximately 1 1/2 years ago as her brother was diagnosed with Kawasaki Disease and we wanted to be sure we did not miss it in her when she was younger. Any suggestions or insight would be greatly appreciated. Having one child with acquired heart disease has made me much more vigilant to possible rare conditions. Thank You for your time.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 18, 13:51
      Toni: Thanks for your question. This pain sounds very typical of musculoskeletal pain. The feeling of soreness and the location are typical of non-cardiac pain. It certainly sounds a little like costochondritis, however that is typically worse with a deep breath. I feel even more comfortable with the assessment that this is not cardiac given that she previously had a work up for Kawasaki Disease. Have you tried to see how effective non-steroidal medications such as ibuprofen might be? Given the duration of her pain, it might help to relieve the pain. Hope that helps.
  28. Amy March 17, 22:47
    Hi, my son is 17 and he has been very active and participated in many sports. About 8 months ago he started having problems with chest pains on the left side during exercise. He can only exercise for about 8 minutes and then he gets chest pains, shortness of breath, light headed, and his left shoulder and neck hurt. We have seen the doctor and have done a stress test. The doctor said his pulse and blood pressure or something like that reached really dangerous levels, but they couldn't figure out why. Could this be related to the heart at all? Thanks
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 18, 13:51
      Amy: While the description of your son's pain makes a heart source a little more likely (pain only with exercise with other associated symptoms), there is still a greater chance that the pain is not heart related. I am confused by their description of the stress test (and it sounds like you are as well). I would encourage you to seek some clarification. I view it as the medical team's responsibility to effectively communicate the results of any test. Quite simply, there should be no doubt in the patient or family's mind about what the results mean to the medical team. Everyone's heart rate and blood pressure go up during stress tests, but if your son's numbers reached abnormally high values, this needs to be further clarified. Hope that helps.
  29. Kelly KeRonne March 18, 14:22
    Hello Dr. Madsen, I happened to come across your site while researching information about my 14 year old daughter's ongoing concerns. She has been experiencing moderate pain in her central and left sternum for months as well as a fluttering and vibrating sensation to the left of sternum. Has also complained of a "skipped beat" sensation over the years. She is very active in both soccer and track and has recently increased her amount of running which seems to have aggravated the situation further. She does not have an increase in pain, nor is she short of breath or dizzy, during exercise. Initial diagnosis was costochondritis which did not resolve after 2 weeks of motrin/rest. Her pedatrician would like her to return to see her but my thought is that it may be time to visit a cardiologist. Would appreciate your thoughts/feedback. Thank you! Kelly
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 23, 15:53
      Kelly: This certainly sounds like the stubborn chest pain of adolescence (and by stubborn I mean that it is slow to resolve and often quite frustrating). By your description, it does not sound like the symptoms are not present during exercise, but that more exercise seems to make the symptoms worse when they do occur. As you have read, I worry a lot more about chest pain that happens during exercise, and mostly that is only if there are associated symptoms like severe dizziness and fainting. I think you could go either way in regards to next steps. If the symptoms are the same as last time you saw pediatrician, then maybe the next steps could be reviewed over the phone as opposed to in the clinic. The one piece of advice is that I would discourage ordering any advanced cardiac testing before seeing the cardiologist (if that is recommended). It is best to let the cardiologist determine the appropriate tests to avoid a shotgun approach that often leads to excessive testing and cost. Hope that helps.
  30. G March 20, 12:30
    My child is 6 years old and for the last 2 days she said that her chest hurts when she is running in the playground. She then stops running and then she feels better. Any Ideas?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 23, 15:54
      G: Tough to be specific without more information. What I can tell you is that chest pain is very rarely related to the heart in children, and that at your daughter's age, I worry more about episodes of passing out (which, just to be clear, are also not typically heart related). Keep an eye on her but given the low probability of heart related chest pain in 6 year olds, I suspect she should be well. If you have a family history of childhood heart disease or your daughter has worsening symptoms, then consider a visit with her doctor. Hope that helps.
  31. Sam March 21, 06:15
    Hello, the doctor got back to me and the cardiologist suggested no further action and they aren't worried about me because of my age (16) but when I get the chest pains sometimes I get aches in my left arm or near to top left side of my chest. After I had my ECG scan the doctor said I had a small LVH and I've searched this up on the Internet and it looks worrying but I keep getting the pains and I've got a another appointment soon so should I see the cardiologist just to make sure because in some cases this pain I am getting makes me feel like it's a heart pain and I'm scared about it. Thankyou for reading.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 23, 15:55
      Sam: Best of luck with the visit to the cardiologist. Good idea to have the LVH on the ECG checked out. However, you should know that EKG criteria for LVH are not perfect (depending on which one's were applied to your EKG), and some times the LVH reading is a "false positive". None the less, best to have a full visit to be sure. Hope that helps.
  32. Craig March 21, 17:06
    Hello, I am 19 years old and have been experiencing chest pains for 11 months. The pain occurs on the left side, just inside, and below my nipple. The pain is consistently dull and occurs at any time at random(sitting or walking around). ***It usually lasts from anywhere from 20 mins to a couple hours to all day. This also happens every day. I read online, and see that there are many pains associated with heart related issues. Here are mine that seem to be related to a heart issue. -pain in the left forearm (thumb side) -pain in left shoulder -pain in left neck -anxiety -pain in upper back ***The upper back pain is inside the left shoulder blade usually occurs 10 minutes into a run and it aches. It also occurs randomly throughout the day ***The left forearm pain is more of a *zing* or *shock* sensation and doesn't last longer than 2-4 during exercise, and is consistent with happening after about 8 miles into a run. ***Left shoulder pain comes at random throughout the day but not every day Exertion does not seem to make the chest pain noticeably worse, but I can feel that it is definitely there. I have never passed out or experienced shortness of breath. Also, I get this left side twitch in my neck, and I was wondering if that could have anything to do with my artery fluttering? I went to the doctor and scheduled a stress test. It came back normal, except there was a possible Left Ventricular Hypertrophy. I am a marathon runner and hearing that makes me nervous. (last intense run i have done was December 15th, 11mi run, but have cut down because I am nervous) I haven't had the chance to talk to my GP yet about the test because she is out of town until April 15th. My mother had SVT(fixed with abrasion, and i never get a heart rate over 175 or experience her symptoms) and grandpa had a heart attack at 48, and survived until he was 80. Other than that no other heart issues in my family. Sorry for the long post, just need an opinion. Thank you!
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 23, 15:52
      Craig: Thanks so much for your question. You have obviously thought a lot about your symptoms. First thing to mention, and for the benefit of other readers as well, the chest pain symptoms you mention are classic for adult heart related chest pain. While your age makes you an adult, thankfully in this case, your age bracket is much more pediatric. I usually make the division for adult vs pediatric chest pain more around 30 years old. Beyond the usual elements, it is quite reassuring that your stress test was normal. The LVH is more subtle. It sounds like you are a prolific runner, and a "runner's heart" is in general thicker and can be misunderstood as an abnormality. This certainly needs to be sorted out with your GP as you mention, but given the absence of a family history specific for cardiomyopathy, the odds are that your stress test LVH is more likely related to your level of fitness. Talk to your GP, but by the sounds of it, it seems like the chest pain is more in the skeletal muscle and hopefully you can receive full clearance soon to return to running. Hope that helps.
  33. One Very Frustrated Mom March 23, 16:04
    HI! My son is 5. He has been complaining with his chest hurting for at least 6 months now. It started when he was 4. He will stop whatever it is that he is doing at the time and grab his chest. He always has this really sad, almost scared look on his face. Most of the time he tells me that the pain is in the center of his chest, sometimes its either to the left or right side. Most episodes happen while he is eating, however it has also happened several times while resting, playing etc. It happens at school, home, in the car, anywhere. It has even woke him up from sleeping before. I have been keeping records of his complaints. This happens very frequently. By frequently, I mean that out of the last 28 days, he has complained of this 34 different times. He sometimes tells me that "it feels like a fish flouncing around in my chest". "a stick poking me" and just a couple of weeks ago he was eating, and suddenly stopped, grabbed his chest, looked at me and said "I wish someone could cut my chest open and make it stop hurting". Guess you can imagine how that made me feel!!! I was diagnosed with WPW when I was younger and had to have cardiac ablation done on both sides of my heart, I was told by my cardiologist that my problem was most likely there since birth and only worsened as stress became a part of my life. I was also told that WPW was hereditary. There is a pretty significant history of heart issues in our family. This made me even more concerned. I took my son to his pediatrician, who done an ekg (normal), but so were all of my ekgs. The only way they caught mine was thru me wearing a heart monitor. His doctor told me to simply watch him. A few months passed and he still complained of these chest pains, so I took him back. The dr then informed me that he thinks it is acid reflux, started him on Zantac and referred us to a peds gastro specialist. My son was seen there mid feb. this year, they started him on Prilosec and continued the zantac. Nothing has changed, like I said out of the past 28 days he has complained 34 times. Most recent complaint was this morning at school, his teacher told me that they were standing up singing, when again he stopped and grabbed his chest. He told her his chest was hurting. She also told me that she noticed something different this time. She said he turned really red and looked like he was going to pop out in a sweat. Also he has had a dry, nagging cough off/on for probably 3 to 4 months now. It's not a hard full force cough like when he is sick, it seems to happen most often when he is running (short distances). He does not always complain of chest pain at the same time of this cough. I have been made feel like I am crazy and that his doctor is tired of seeing him. I fully understand that this could be nothing that will truly harm him, however as a mother I do worry and I want to know what is causing this, I want the doctor to listen to my concerns and not diagnose my son before the he even enters the room. Any suggestions would be appreciated. Thank you
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author March 24, 09:16
      One Very Frustrated Mom: I'm sorry to hear about all the stress and worry you have had over the last 6 months. It certainly appears that you have been doing your best to advocate for your child. In short, here is what I think – you should have your son seen by a pediatric cardiologist. Now that doesn't mean your son necessarily has WPW or any other cardiac condition, however at this point, a thorough review by a cardiologist is the next logical step. I would recommend a Holter monitor (24 hour heart rate/rhythm monitor) given that these events occur daily and thus, the likelihood of capture by the monitor is higher. I think the first step of managing possible reflux related trouble was prudent, but as you explain, that did not alter the symptoms. In addition, a history of a normal EKG does not completely rule out some sort of heart rhythm disturbance (as you know since your WPW was associated with normal EKGs). I hope that helps.
  34. Fawad Khan March 24, 11:23
    Hey Doctor, I am 24years old 5"10-5"11 ft, I weigh around 100-105kgs. Couple of weeks back I started training to slim down and also started skipping rope 200-300 daily but since 3 day of my skipping I feel pain in chest. I don't feel pain while laying down or Walking but I feel pain only when I jump up and down or suppose when I ride a bike and I ride upon a speed breaker my upper body when moves up and down I feel the pain otherwise I am just normal it happens only when am jumping up and down due to this am unable to do excersice related to my upper body movement of up & down. I don't have any medical background except my dad is a diabetic and my mom is high BP patient. I did lot of back stretching and taken rest for 4 days but still the pain occurs when there is movement in my upper body. Kindly suggest me of what is to be done..
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author April 07, 08:19
      Fawad: It sounds like you may have injured yourself with your training. The muscles in the chest, especially between the ribs, are a more common place to injure oneself than most people realize. You may want to try a more extended rest and then a slightly less aggressive start to your training (some times we just have a tendency to over work because of enthusiasm). In the mean time, if walking is not causing any pain, keep that up. 30 minutes of walking per day is so much better than no exercise at all. Hope that helps.
  35. one very frustrated mom March 24, 22:05
    Thank you! I agree with you and would certainly feel better about the whole situation if the doctors would do this, even if it showed nothing.
  36. lola March 25, 00:40
    Hi my daughter is 15 years old. She had a strep throat twice and now (1 week later) she is complaining to me about chest pain after eating or drinking. She has been feeling like this for 2 days and she is complaining that it keeps getting worse. I would very much appreciat a thought or feedback. Thank you
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author April 07, 08:19
      Lola: If your daughter's pain is persistent and remains, I would have her check in with her doctor. I suspect that it has passed at this point, but if not, I would make an appointment to be sure there is nothing else to be done. Hope that helps.
  37. Deborah Goins March 26, 07:19
    Good morning , My granddaughter woke up out of her sleep complaining of chest pain on the right upper side of her chest. She has been sick recently with sinusitis and a viral infection behind her eardrum. I'm very concerned.. Ever after taking her temp which was 97.and calming her down she still complains that her chest hurts and said the pain is now moving from the right side to the center of her chest and back. She was seen in the ER this past week for her ears, coughing and her sinuses and was given Claritin. She is nine yrs old. She woke up straight away crying with her complaint. Her dad has sent her to school, but I'm concerned (worried) about my baby. What should be our next step? Please send something that I can also share with my son. I searched Google which lead me to your page on 6 ways to to help a parent when their child complains of chect pain. I tried to share it with my son, but it brought me to your Facebook. I'm using my iPad. Thank you so much! Ps I'm sorry, but I forgot to check notify me of follow up by email before I posted so I'm sending again. Thank you
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author April 07, 08:20
      Deborah: Hopefully your granddaughter's pain has subsided at this point. It is not uncommon to have muscle pain during an illnesses, and as long as it passes in a relatively short period of time, there is nothing else to be done and there should be no long term negative effects. However, if the pain continues to wake her at this point, I would check in with her doctor. Hope that helps.
  38. Prithy March 26, 10:45
    Hey,I'm a 16 year old girl and I have been having chest pains for about 6 months now. I have gone to see a doctor for about 4 to 5 times and he gave me medicines but it didn't work. I then went to a hospital to get my blood test,ECG and x-Ray checked but everything was perfectly normal. The pain comes and stays for a very long time and it goes for a short period of time and it comes back again. It feels like there is lightning on my chest and it hurts really bad and when i feel pain,my chest becomes swollen and I find it really hard to breathe so I usually just take short breaths. The pain is all over my chest until under my breast. I really don't know what to do and I don't know what is it. My parents are really worried,I am too. Thank you so much in advance.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author April 07, 08:21
      Prithy: I assume the pain you are sharing comes on at random times and is not purely associated with moderate or vigorous exercise. In addition, I assume that you have never passed out in association with these episodes. If both of those assumptions are correct, it is very likely that your pain is not heart related. Of course, knowing this information doesn't make the pain go away, but hopefully it helps relieve some of the worry. Teenagers can often experience chest pain for many months. Does ibuprofen help? Sometimes this is the only thing that helps. Of course, I don't advise taking ibuprofen every day for months. Hope that helps.
  39. Jenny March 27, 14:58
    Hello. My name is Jenny, and I am currently 15 years old. I had these sharp chest pains (both sides, but most commonly the left side), and I had them since I was 12. Usually, it hurts for about minute or less, so I would just stop what I was doing. I had noticed that when I breathe shallowly, and then make my breaths bigger and bigger, it would hurt a little each time, but once I breathed to a certain "point" (not sure how to call this), it would stop hurting until I took a bigger breath, and I kept doing that until I could breathe deeply and not hurt. Recently they've been getting worse. Yesterday though, I woke up in the middle of the night, and my breathang thing I usually did didn't work, and it hurt to move, even though I forced myself to sit up, but even straightening my back hurt. It lasted about 12 minutes, and that's the part I'm worried about. My mom has scheduled a doctor appointment in 2 weeks, but I'm still worried... I have been stressed lately (too much homework and projects in school), but do you think stress would cause something like this? I know in your article you'd said it might be stress, but not being to breathe normally (only shallow breaths) for 12 minutes makes me feel like it isn't stress. But then again, I'm not a doctor. Sorry for this long post, thank you!
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author April 07, 08:22
      Jenny: You may have already seen your doctor - it which case I hope you were able to sort out the nature of your chest pain. If I correctly understand your explanation of the breathing you are doing during these episodes, it makes sense to me. When the muscles in the chest are hurting, any stretching makes that pain worse. This can be performed by pushing on the chest, or it can be generated by taking a deep breath and stretching the chest muscles from the inside. Three years is a long time to have this sort of pain. Hope that helps.
  40. Lisa March 28, 00:17
    My son is 9 yrs old and has been complaining about his heart hurting. Sometimes I'm the front and back of his chest. It happens at random times too. When he's walking or lying down. My concern is that I took Zoloft in my 3rd trimester when I was pregnant and in the past few years have found it to cause birth defects. Do you think I should be concerned and get him checked out? I'm so worried about it because my Husband had a heart attack at 39. Any advice would be greatly appreciated.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author April 07, 08:23
      Lisa: Zoloft in the third trimester is not known to be associated with any heart problems in the developing baby's heart. In fact, the heart is finished with most of its development by 8-10 weeks into the pregnancy, which is long before the third trimester. In addition, your son's chest pain at random times and in random places sounds a lot more like non-heart related muscle pain in the chest. However, your comment that your husband had a heart attack before the age of 40 does reinforce that I would make sure you follow the American Academy of Pediatrics recommendation to have your son's cholesterol levels checked by his 10th birthday. Cholesterol is not likely to be the reason that your son is having chest pain, but it could cause issues at a later time and I would recommend you talk to his doctor about screening. Hope that helps.
  41. rabia March 31, 12:54
    Hi m 18 years old girl.I m facing pain in my left shoulder blade which goes down to left arm and chest..the pain very rarely occurs at right shoulder blade and middle of both shoulder blade and arm to fingers..I often feel headache nearly 4/5 times a day.. I m also experiencing tightness,burning, and ache in the middle of my chest sometime the pain occurs at the right side of my chest also.. I have went to doctor before she told me its just due to the deficiency of iron..but at that time I was not having much pain in my shoulder blades and I didn't tell her about this pain.. But from past 7 days the pain has increased ..sometimes when I just change my place like from one chair to another my heart starts beating fastly.. I haven't slept in new way or new bed..and am nt participating in any physical activity ..I participated in 50m race 2 years ago..but that time nothing was there..I would like to describe my symptoms in short.. 1.burning,tightness and aching in the middle of my chest.Aching is sometimes in the right side and also more often in the left.. 2.pain in the middle of the shoulder blade more often in the left shoulder blade and left arm down to the fingers and very rare on right side. 3.pressure in chest which sometimes increases and cause shortness of breath and cough that stays just for 2/3 seconds ..(cough and shortness of breath occurs like just 1/2 times in two weeks) 4.head ache (any time..from wake up to sleep) 5.undefined weakness 6.need to go to washroom alot (more than 8 times an hour)..sometimes I just come out from the washroom and feel like I need to pee again 7.stress for no reason 8.also when I dont go to washroom I feel sharp pain in my kidneys and chest 9.irritation from crowded and noisy places (I feel dizzy if I stay at these type of places for more than 20 minutes) My post is too long but hope for reply .
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author April 07, 08:25
      Rabia: I would definitely make an appointment with your doctor to discuss your symptoms. It sounds like you are troubled by several issues simultaneously and it would be best to review these in detail with a physician in person. Sorry I cannot offer more insight.
  42. Sam April 02, 11:52
    I've been to the doctors 5 times now and the fifth time was today. After my ECG the doctor told me that there was a small LVH which I have discussed on here already and after the fourth time the doctor told me the cardiologist isn't worried or anything etc, but today I told the doctor how I get aches and pains in my left arm ( usually pains and aches in the left arm are a sign of heart problems right?) I told her how sometimes throughout the day my left ankle and leg feels a bit achey etc. She still thinks it's note heart and has prescribed me with 400mm iborporfen, then in 4 weeks if it hasn't gone go back again. I'm really scared because of the aches and pains I get throughout the day.
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author April 07, 08:15
      Sam: You are right that pains and aches in the left arm can be a sign of heart trouble, but that is in the setting of a heart attack and is accompanied by other signs and symptoms. Daily left arm pain is much more likely to not be related to the heart, especially in those less than 30 years old. Remember that the body is a complicated machine, and sometimes there is overlap in symptoms between things that are more innocent like muscle pain and things that are more worrisome like a heart attack. Hope that helps.
  43. Mike April 02, 12:02
    Hi Doc My son is 16 and is very active in sports. 2 months ago he was sitting in class and his stomach and chest started to hurt. I immediately took him to the doctors and then later to a cardiologist. Both appointments showed nothing to be alarmed about. The stomach pain went away but the chest pain is still lingering in the middle of his chest after 2 months. It hurts at times to the touch and when he runs hard he says it's about a 3 or 4 out of 10. We did every test with good results but I'm concerned. Any feedback would be greatly appreciated. Thank you
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author April 07, 08:16
      Mike: It sounds like your son received an extensive workup and you should feel comfortable that his heart is healthy. The truth is that any chest pain that can be replicated by pressure on the chest (by touch) is not related to the heart. The heart does not hurt because of this type of external pressure. Your son is likely experiencing the much more common chest wall muscle pain and this will subside with time. Hope that helps.
  44. Brooke April 02, 22:00
    Hi Dr. Madsen, My son is eight years old. For the last week and a half he has complained of instant severe chest pain. The first time it happened he was sitting at the table reading a book when he stood up walked halfway across the room and stopped and he was holding his chest and squeezing his shirt. I asked him what was wrong he said that his chest hurts really bad and it hurts to breathe. It only lasted about 45 seconds and then he was fine. He said it happened at school yesterday and it happened again tonight while we were eating dinner. I was standing in the kitchen and he stood up and came over to me he was very pale he looked scared and he was doing the same thing again he was squeezing his chest towards the middle to right side and he said it hurts really bad and he was saying that his chest hurt really bad and when he breaths it hurts even worse. He has not been sick recently and no other symptoms other than complaining of his stomach hurting a couple of days ago. Should I be concerned?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author April 07, 08:17
      Brooke: It is probably best to discuss this with your son's doctor. It certainly sounds like he is experiencing something sudden and uncomfortable. There is a strong likelihood that it is not related to the heart, but given his younger age than the typical episodes of chest wall muscle pain, I would discuss this with his doctor. Hope that helps.
  45. Brittany April 03, 10:12
    Hi, my daughter is 14, and has been complaining about cheats pain the last couple of weeks it useally happens at night time, it also hurts so much where it gets to the point where it hurts to breath, my daughter also has a heart condition and others related to the heart. Should I be worried?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author April 07, 08:08
      Brittany: It's hard to give advice to your question without knowing more detail about your daughter's heart condition. Certainly a significant heart condition makes chest pain a potentially more worrisome issue and may require an assessment by a doctor. On the other hand, a history of a heart condition does not prevent a child from having common non-cardiac chest pain as well. Thus, given your daughter's history, it is probably best to speak with her regular doctor. Hope that helps.
  46. Rachel April 03, 19:09
    Hello, My daughter has just turned 7. Last year on random occasions she complained of chest pains. In early January she had severe pains that had her clutching her chest and screaming crying for a half hour then they stopped as suddenly as they came on. The veins going up her chest on the left side were almost navy in colour. She had pains a few more times but not to the same extent. Two weeks ago she had the crippling pains again which had her screaming crying again for about 30 minutes also her veins a lot more visible and bluer. In the last two weeks the pains have become more frequent but haven't returned as strong. However on a couple of occasions they've been strong and completely stopped her in her tracks. She's curled up on my knee whimpering. She isn't a child that cries easily, she quite tough. She plays sport and it never happens while active. She is on ditropan for a bladder issue that arose when she was 4. She has a very mild heart murmur which doesn't seem to be an issue. She has had 2 ECG's which have both shown a dropped beat which also seems to be irrelevant. She had an X-ray which showed up clear too. We are due to see a cardiologist in a few months. Any ideas on what could be causing this? Many thanks R
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author April 07, 08:10
      Rachel: Hard to know what exactly is causing this. It is more unusual given her age and the duration of the symptoms. Have you attempted to count her heart rate (this can be performed by placing your hand on her chest)? It would be relevant for your visit with the cardiologist to know if her heart rate is very high during these episodes (more than 180 beats per minute) or just mildly high consistent with pain (around 120-150 beats per minute). You may want to practice a few times when she is not in pain. Hope that helps.
  47. stacy April 03, 20:23
    MY 11 year old son is complaining of his heart hurting and he has a big game tommorow should he take a medicine
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author April 07, 08:11
      Stacy: My guess is that your son has already had his big game. I suspect that your son is likely confusing "heart" pain with chest pain, which in pediatrics is not the same thing thankfully. If his chest pain returns, I would consider it in terms of the information from the blog post above. Hope that helps.
  48. Claire Featherstone April 04, 01:10
    Hi, my 10 year old type 1 diabetic son (diagnosed at 8) has started complaining of a severe pain in the centre of his chest, it happens when resting/walking about/sleeping - there does not seem to be a trigger, it lasts about half an hour most times and doesn't seem to be linked to food either. I did try an antacid tablet but that didn't seem to help. I do intend to take him to the doctors, but its Easter weekend and doctors are a little thin on the ground. Obviously if it goes worse I will take him to the hospital to be checked, but I just wondered if it could be anything to do with his diabetes. Thank you
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author April 07, 08:12
      Claire: I do not suspect that the chest pain is related to his type I diabetes. I assume that you have not appreciated any association with hypo or hyper glycemia (not that I would suspect any association). Rather, I think that both are true but unrelated - meaning that your son is having normal musculoskeletal chest pain and has type I diabetes. However, as I have advised other families on this blog, those with kids who have chronic medical conditions, the recommendations are a little different and I would advise discussing symptoms with your doctors a little earlier. Hope that helps.
  49. Lorena April 04, 22:36
    Hi , my son is 14 he's been having chest pains for almost a month I think . It's not a really big pain it's not really a strong pain it's a weak pain he can ignore it , but when he's laying down or sitting down he can feel the pain he's been coughing though but he stopped a day ago and it's still hurts not as much as then but still . He's scared it might be something serious what is it ?
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author April 07, 08:13
      Lorena: It sounds like the common chest pain of adolescence. How does it compare to the chest pain discussed in this blog or in some of the previous Q&A's I have addressed? While it can be hard to say definitely "what it is" exactly, it is often fairly straight forward to determine that it is not related to the heart. Hope that helps.
  50. Amal April 05, 10:07
    Hi my daughter is 5 and she complains that her heart hurt,she is health child and very active,she complains yesterday and today I don knows what to do,I don want to panic what should I do
    • Dr. Nicolas Madsen
      Dr. Nicolas Madsen Author April 07, 08:14
      Amal: While I know that your daughter said that her "heart hurt", what she probably means is that her chest hurts. I would watch her for any concerning symptoms (fainting, difficulty breathing, severe fatigue) or if the pain becomes frequent or more severe, and if any of those things happen, then I would advise consulting with her regular doctor. Hope that helps.