Çocuklarda Göğüs Ağrısı

Year 2023, Volume: 17 Issue: 4, 328 - 333, 25.07.2023

Utku Pamuk , Alper Gürsu

https://doi.org/10.12956/tchd.1287099

Abstract

Göğüs ağrısı, çocukluk çağında acil servis, pediatri ve çocuk kardiyoloji kliniklerine en sık başvuru nedenlerinden biridir. Ağrı genellikle ciddi bir nedenden kaynaklanmasa da, hasta ve ebeveynleri için endişe kaynağı olabilir. Klinisyenler, altta yatan önemli bir neden olduğunu düşünmedikçe, aileyi göğüs ağrısının iyi huylu doğası hakkında bilgilendirmelidir. Aile ve hasta kaygısını arttırdığı ve gereksiz değerlendirmelere neden olabileceği için bu hastaların rutin olarak kardiyoloji bölümüne sevk edilmesi önerilmemektedir. Göğüs ağrısı her yaşta ortaya çıkabilir, ancak 10 yaşından sonra görülme sıklığı artar. En sık nedenler kostokondrit, travma veya kas gerilmesine bağlı göğüs duvarı kas ağrısı ve solunum yolu hastalıklarıdır. Kardiyak nedenlerin prevalansı %6'dan daha azdır ve daha ileri tanısal çalışmalar her zaman gerekli değildir.

Keywords

göğüs ağrısı, çocuklar, pediatrik kardiyoloji

Chest Pain in Children

Abstract

Chest pain is one of the most common reasons for admission to the emergency department, pediatrics and pediatric cardiology clinics in childhood. While pain is not usually caused by a serious cause, it can be of concern to the patient and their parents. Clinicians should inform the family of the benign nature of chest pain, unless they consider an important underlying cause. Routine referral of these patients to the cardiology department is not recommended, as it increases family and patient anxiety and may cause unnecessary evaluation. Chest pain can occur at any age, but its incidence increases after 10 years of age. The most frequent causes are costochondritis, chest wall muscle pain due to trauma or muscle strain and respiratory tract diseases. Cardiac reasons are rare with a prevalence of less than 6% and further diagnostic studies does not always necessary.

Keywords

chest pain, children, pediatric cardiology

References

• Yeh TK, Yeh J. Chest pain in pediatrics. Pediatric Annals 2015;44:e274-e8.
• Öztürk K, Çetin İİ, Ekici F, Kocabaş A, Şaylı TR. Etiology of Chest Pain in Children. Turkish J Pediatr Dis 2015;9:248-53.
• Park MK. Child with Chest Pain. Pediatric cardiology for practitioners E-Book: Elsevier Health Sciences 2014.
• Fyfe DA, Moodie DS. Chest pain in pediatric patients presenting to a cardiac clinic. Clinical pediatrics 1984;23:321-4.
• Öztürk K, Çetin İ, Özışık K, Ekici F, Şaylı TR. A Rare Cause of Chest Pain in Children: Spontaneous Pneumomediastinum. Turkish J Pediatr Dis 2013;7:1-3.
• Chun JH, Kim TH, Han MY, Kim NY, Yoon KL. Analysis of clinical characteristics and causes of chest pain in children and adolescents. Korean J Pediatr 2015;58:440.
• Johnson JN, Driscoll DJ. Chest pain in children and adolescents. Moss and Adams’ Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young Adult: Ninth Edition: Wolters Kluwer Health Adis (ESP); 2016.
• Selbst SM, Ruddy RM, Clark B, Henretig FM, Santulli Jr T. Pediatric chest pain: a prospective study. Pediatrics 1988;82:319-23.
• Aeschlimann A, Kahn M. Tietze’s syndrome: a critical review. Clin Exp Rheumatol 1990;8:407-12.
• Fishman SM. Bonica’s management of pain: 4th ed. Philedelphia: Lippincott Williams & Wilkins; 2012.
• Ives A, Daubeney P, Balfour-Lynn I. Recurrent chest pain in the well child. Arch Dis Child 2010;95:649-54.
• Agha BS, Sturm JJ, Simon HK, Hirsh DA. Pulmonary embolism in the pediatric emergency department. Pediatrics 2013;132:663-7.
• Berezin S, Medow M, Glassman M, Newman L. Chest pain of gastrointestinal origin. Arch Dis Child1988;63:1457-60.
• Kenar A, Örün UA, Yoldaş T, Kayalı Ş, Bodur Ş, Karademir S. Anxiety, depression, and behavioural rating scales in children with non-cardiac chest pain. Cardiol Young 2019;29:1268-71.
• Pillay A, Lalloo M. Psychogenic pain disorder in children. S Afr Med J 1989;76:195-6.
• Neill WA, Hattenhauer M. Impairment of myocardial O2 supply due to hyperventilation. Circulation 1975;52:854-8.
• Gumbiner CH. Precordial catch syndrome.(Featured CME Topic: Precordial Catch Syndrome). South Med J 2003;96:38-42.
• Fam AG, Smythe HA. Musculoskeletal chest wall pain. CMAJ 1985;133:379-89.
• Aygun E, Aygun ST, Uysal T, Aygun F, Dursun H, Irdem A. Aetiological evaluation of chest pain in childhood and adolescence. Cardiol Young 2020;30:617-23.
• Saltzman DA, Schmitz ML, Smith SD, Wagner CW, Jackson RJ, Harp S. The slipping rib syndrome in children. Pediatr Anesth 2001;11:740-3.
• Pantell RH, Goodman Jr BW. Adolescent chest pain: a prospective study. Pediatrics 1983;71:881-7.
• Massin MM, Bourguignont A, Coremans C, Comté L, Lepage P, Gérard P. Chest pain in pediatric patients presenting to an emergency department or to a cardiac clinic. Clin Pediatr 2004;43:231-8.
• Veeram Reddy SR, Singh HR. Chest pain in children and adolescents. Pediatr Rev 2010;31:e1-e9.
• Freedman SB, Haladyn JK, Floh A, Kirsh JA, Taylor G, Thull-Freedman J. Pediatric myocarditis: emergency department clinical findings and diagnostic evaluation. Pediatrics 2007;120:1278-85.
• van Loon RLE, Roofthooft MT, van Osch-Gevers M, Delhaas T, Strengers JL, Blom NA, et al. Clinical characterization of pediatric pulmonary hypertension: complex presentation and diagnosis. J Pediatr 2009;155:176-82. e1.
• Fikar CR, Amrhein JA, Harris JP, Lewis ER. Dissecting aortic aneurysm in childhood and adolescence: case report and literature review. Clin Pediatr 1981;20:578-83.
• Care RP. Health supervision for children with Marfan syndrome. Pediatrics 2013;132:e1059-e72.
• Sabri M, Ghavanini A, Haghighat M, Imanieh M. Chest pain in children and adolescents: epigastric tenderness as a guide to reduce unnecessary work-up. Pediatric Cardiol 2003;24:3-5.
• Friedman KG, Alexander ME. Chest pain and syncope in children: a practical approach to the diagnosis of cardiac disease. J Pediatr 2013;163:896-901. e3.
• Durani Y, Egan M, Baffa J, Selbst SM, Nager AL. Pediatric myocarditis: presenting clinical characteristics. Am J Emerg Med 2009;27:942-7.
• Brown JL, Hirsh DA, Mahle WT. Use of troponin as a screen for chest pain in the pediatric emergency department. Pediatr Cardiol 2012;33:337-42.
• Chamberlain RC, Pelletier JH, Blanchard S, Hornik CP, Hill KD, Campbell MJ. Evaluating appropriate use of pediatric echocardiograms for chest pain in outpatient clinics. J Am soc Echocardiogr 2017;30:708-13.