Chest Pain

Is this your child's symptom?

• Pain or discomfort in the chest (front or back)
• The chest includes from the top to the bottom of the rib cage

If NOT, try one of these:

• Asthma Attack
• Cough

Causes of Chest Pain

• Muscle Overuse. Chest pain can follow hard sports (such as throwing a baseball). Lifting (such as weights) or upper body work (such as digging) can also cause it. This type of muscle soreness often increases with movement of the shoulders.
• Muscle Cramps. Most brief chest pain lasting seconds to minutes is from muscle cramps. The ribs are separated by muscles. These fleeting pains can also be caused by a pinched nerve. These chest wall pains are harmless. Brief muscle cramps are also the most common cause of recurrent chest pains. The medical name is precordial catch syndrome.
• Coughing. Chest pain commonly occurs with a hacking cough. Coughing can cause sore muscles in the chest wall, upper abdomen or diaphragm.
• Asthma. Children with asthma often have a tight chest. They may refer to this as chest pain. They also get chest pain when they have lots of coughing.
• Heartburn. Heartburn is due to reflux of stomach contents. It usually causes a burning pain under the lower sternum (breastbone).
• Caffeine. A rapid and pounding heart beat may be reported as chest pain. Too much caffeine as found in energy drinks is a common cause. Drugs prescribed for ADHD also can cause a fast heartbeat. Illegal drugs, such as cocaine, can cause a high heart rate as well.
• Chest Wall Injury. Blunt trauma usually just causes a bruised rib. Sometimes, it causes a rib fracture.
• Heart Disease (Serious). Heart disease is hardly ever the cause of chest pain in children. Chest pain that only occurs with exercise could have a cardiac cause.
• Pleurisy (Serious). Pleurisy is another problem of pneumonia. If the infection involves the lung's surface, that area of the chest will hurt.

Pain Scale

• Mild: your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
• Moderate: the pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
• Severe: the pain is very bad. It keeps your child from doing all normal activities.

When to Call for Chest Pain

Care Advice

Sore Muscle Pain Treatment

1. What You Should Know About Mild Chest Pain:
   • Chest pains in children lasting for a few minutes are usually harmless. The pain can be caused by muscle cramps. They need no treatment.
   • Chest pains that last longer can be from hard work or sports. The shoulders are usually involved. Sore muscles can start soon after the event.
   • Here is some care advice that should help.
2. Pain Medicine:
   • To help with the pain, give an acetaminophen product (such as Tylenol).
   • Another choice is an ibuprofen product (such as Advil).
   • Use as needed.
   • Continue this until 24 hours have passed without pain.
3. Cold Pack for Pain:
   • For the first 2 days, use a cold pack to help with the pain.
   • You can also use ice wrapped in a wet cloth.
   • Put it on the sore muscles for 20 minutes, then as needed.
   • Caution: avoid frostbite.
4. Use Heat After 48 Hours:
   • If pain lasts over 2 days, put heat on the sore muscle.
   • Use a heat pack, heating pad or warm wet washcloth.
   • Do this for 10 minutes, then as needed.
   • Reason: increase blood flow and improve healing.
   • Caution: avoid burns.
   • A hot shower may also help.
5. Stretching the Muscles:
   • Gentle stretching of the shoulders and chest wall may help.
   • Do sets of 10 twice daily.
   • This may prevent muscle cramps from coming back.
   • Stretching can be continued even during the chest pain. Do not do any exercises that increase the pain.
6. What to Expect:
   • For sore muscles, the pain most often peaks on day 2.
   • It can last up to 6 or 7 days.
7. Call Your Doctor If:
   • Pain becomes severe
   • Pain lasts over 7 days on treatment
   • You think your child needs to be seen
   • Your child becomes worse

Heartburn (Reflux) Pain Treatment

1. What You Should Know About Heartburn:
   • Heartburn is common.
   • It's due to stomach acid going up into the esophagus. The esophagus is the tube from the mouth to the stomach.
   • Heartburn causes a burning pain behind the lower part of the breastbone. It also causes a sour (acid) taste in the mouth and belching.
   • Here is some care advice that should help.
2. Antacids:
   • Heartburn is usually easily treated. Give a liquid antacid by mouth (such as Mylanta or the store brand). No prescription is needed.
   • Dose: give 1 to 2 tablespoons (15 - 30 mL).
   • If you don't have an antacid, use 2 to 3 ounces (60 - 90 mL) of milk.
   • For heartburn that keeps coming back, give an antacid 1 hour before meals. Also, give a dose at bedtime. Do this for a few days.
3. Heartburn Prevention:
   • Do not eat too much at meals. This overfills the stomach.
   • Do not eat foods that make heartburn worse. Examples are chocolate, fatty foods, spicy foods, carbonated soda, and caffeine.
   • Do not bend over during the 3 hours after meals.
   • Do not wear tight clothing or belts around the waist.
4. What to Expect:
   • Most often, heartburn goes away with treatment.
   • But, heartburn also tends to come back. So, preventive measures are important.
5. Call Your Doctor If:
   • Heartburn doesn't go away after 2 days of treatment
   • You think your child needs to be seen
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2000-2023. Schmitt Pediatric Guidelines LLC.