PT  - JOURNAL ARTICLE
AU  - B. H. Rowe
AU  - C. S. Dulberg
AU  - R. G. Peterson
AU  - P. Vlad
AU  - M. M. Li
TI  - Characteristics of children presenting with chest pain to a pediatric emergency department
DP  - 1990 Sep 01
TA  - Canadian Medical Association Journal
PG  - 388--394
VI  - 143
IP  - 5
4099  - http://www.cmaj.ca/content/143/5/388.short
4100  - http://www.cmaj.ca/content/143/5/388.full
SO  - CMAJ1990 Sep 01; 143
AB  - Chest pain among children is a common complaint in primary care practice. However, the demographic features and treatment of such patients are controversial. We distributed a questionnaire to 336 consecutive patients with a complaint of chest pain seen during 1 year at an urban pediatric emergency department. Such visits represented 0.6% of all emergency encounters; the male:female ratio was 1.0. Physical examination was done in 325 patients. Chest-wall pain was the most common diagnosis (in 28% of cases). Other causes included pulmonary (in 19%), minor traumatic (in 15%), idiopathic (in 12%) and psychogenic (in 5%); miscellaneous causes (in 21%) most often indicated pain referred from the upper respiratory tract and the abdomen. The most common physical finding was chest tenderness (in 41% of cases). Investigations included chest radiography (in 50% of cases), electrocardiography (in 18%) and determination of the hemoglobin concentration and of the leukocyte count (in 13%); the results were rarely positive. Only eight patients (2%) required admission to hospital, and there were no cases of myocardial ischemia. The findings suggest that health care costs may be reduced by more judicious use of investigations. We conclude that chest pain is an uncommon and usually benign complaint in the pediatric emergency department. Most causes are evident on careful physical examination.