Diagnostic and therapeutic challenges of chest pain in children: a single center study

Background Pediatric chest pain is a common reason for Emergency Department (ED) visits, but it is rarely due to serious cardiac issues. The causes are mainly non-cardiac and include musculoskeletal, gastrointestinal, respiratory, and psychogenic origins. Material and methods This study aimed to assess the causes of chest pain and their correlations with clinical and demographic factors among children and adolescents from eastern Poland. A retrospective analysis covered 1,849 pediatric chest pain cases from 189,282 emergency department visits at the University Children’s Hospital between 2018-2023. Pain characteristics, clinical data, comorbidities, and treatment approaches were evaluated. Results The most common causes were idiopathic (60.48%) and musculoskeletal (22.29%). Hospitalizations for pulmonary-related issues accounted for 12.44%. Physical activity often worsened pain, with dyspnea and palpitations as frequent comorbid symptoms. Bronchial asthma was the most common comorbidity (4.04%). Caffeine intake and smoking were linked to increased stabbing pain. Treatment was needed in 26.07% of cases, mostly conservative. Conclusions Pediatric chest pain is rarely linked to serious conditions. Most cases are mild and effectively managed conservatively. Factors such as stimulants and psychogenic causes play a role, while cardiac causes remain uncommon.