[Dr. Nicolas Madsen]
One of the questions that I hear a lot from patients who come see me in clinic
is about chest pain; chest pain in their children from young ages of 5 and 6, to throughout their teenage years.
Well, with this video what we're really hoping to accomplish is to begin to let families
and kids themselves know how common chest pain really is in children.
In particular, what we want them to know is it's really less than one percent of the time
in children that chest pain has anything to do with their heart,
uh--and in fact, for me when I hear about chest pain, it is most often something not related
to the heart, something related to the muscles in the chest wall,
or some other, less serious condition.
I think we're things about chest pain that makes it difficult for patients and families,
and for kids and families really is that it can be very, very painful.
So painful that they are brought to tears, that they can feel short of breath,
and then of course having chest pain makes you worried about your heart
because you see movies or you've had relatives who had chest pain as adults,
and then serious things have happened.
And so it's a real pain, it's a real significant pain,
and on top of that, it's in a place where people worry something really dreadful is happening.
The way that chest pain is described to me most often by kids themselves or their parents,
who are retelling it, is that they describe short, brief periods of chest pain that occur really at random times.
It can be with activity or could also be watching TV, or doing their homework, or while eating...
Often, the word the kids are going to use is "stabbing" chest pain,
and that can really be anywhere in the chest, but they'll use that sort of "stabbing" word,
and then often what they'll tell me is that they feel short of breath,
and not that, you know--they just feel like it hurts to take a deep breathe.
The pain part about it, it's not that the pain isn't serious, of course it matters a lot that there's a lot of chest pain,
but the more painful it is, it does not associate with the more likely it's heart-related,
and so really the--the amount of pain for me isn't a barometer of how significant,
or how likely it is to be related to the heart itself.
I get told a lot by--this is usually from the parents of younger kids, maybe sort of ages 5 to 10--
who tell me my child describes their heart hurting,
and literally that's the words that, that the child is using, and of course that's very alarming.
What they really mean is that their chest hurts,
and they've learned that their heart sits in the middle their chest, and so they
don't make any distinction between their chest muscles and their heart itself.
The chest pain age groups? Most commonly this is something you see in adolescents,
sort of 13 to, you know,19-year-olds; however, chest pain can exist in young children,
and I've seen it in 4 and 5-year-olds who have described very clearly to me
that their chest is hurting.
Uhm--and while that may be for a reason that's different than why the teenagers have chest pain,
it is still very unlikely to be heart-related.
One of the things that I often ask the kids themselves or the parents is about
whether the pain can be reproduced by pressure on the chest.
And if they come and see me in clinic, I'll reproduce that myself on the physical exam.
And really, if you can push on the chest and make the pain worse, you're not pushing on the heart.
You're pushing on the--the chest pain muscles,
and that is not heart related, and so you know whether it's taking a deep breath in,
stretching the chest from the inside, or pushing from the outside,
if that is bringing up that chest pain, you can feel very confident that it's in the chest muscle,
and the pain is not from the heart.
I think the main features where I get worried again, is that chest pain with activity,
certainly anything chest pain and passing out at the same time, those two together
are quite worrisome.
I think if the chest pain has been going on for some time, and it's very stressful for the kid,
that may be helpful to go see your local pediatrician or family doctor,
and get that reassurance that this is actually not related to the heart.
But most the time I think you can begin to rule it out by noticing that it's these short, brief
moments of chest pain that can be reproduced by pushing on the chest,
you can begin to feel quite confident that in fact this is not heart-related.
Again, it might be quite painful and it might last for sometimes weeks to months at a time,
and that's--that's of course difficult for the child and for the parent who's worried the entire time.
So again, you know, if you've been worrying for a long time, go talk to your doctor.
But feel comfortable when you're talking to your doctor that you'll be talking about pain from a source other than the heart.