Chest Pain in Children: When Should You Worry?

Your child approaches you with a hand on their chest directly over their heart. The look on their face says that something is very, very wrong. “It hurts,” they say between painful gasps. “It hurts a lot.”

Moments don’t get more terrifying for parents. But here’s something to put your heart at ease: Chest pain in children is typically NOT a sign of a serious health condition — and rarely does it have anything to do with their heart or lungs.

So, what’s probably causing that scary chest pain? Let’s get some answers from pediatric cardiologist Kenneth Zahka, MD.

How children may describe chest pain

Let’s start with an uncomfortable reality. Chest pain in children can be stunning in its intensity. Kids may describe a stabbing pain — and it’s frequently felt on the left side of their chest over their heart.

This unexplained pain is often diagnosed as precordial catch syndrome, or PCS. (It’s also known as Texidor’s twinge, with the name referencing one of the physicians who first identified the syndrome in 1955.)

Aside from intensity and location, other common symptoms of PCS include chest pain:

• Lasting only seconds or minutes before suddenly disappearing.
• Getting worse when your child inhales, exhales or moves.
• Affecting children and adolescents who are otherwise healthy.
• Not being triggered by physical activity.
• Often occurring while your child is at rest.

Now the good news: The most harm PCS typically does is cause worry. “It isn’t dangerous or life-threatening and usually resolves by adulthood,” states Dr. Zahka.

What causes precordial catch syndrome?

What causes PCS in children isn’t known for sure, but some believe the pain involves a compressed nerve or muscle cramp, says Dr. Zahka.

What’s agreed upon, though, is that the chest pain is not due to a heart issue.

Treatment for PCS

What can you do about PCS if it suddenly appears in your child? Basically, wait it out. Remember, the pain usually only lasts for a few minutes before vanishing.

If the pain recurs, you may want to try an anti-inflammatory medicine like ibuprofen.

Other typical causes of chest pain in children

PCS is just one explanation for chest pain in children. That hurt also could be due to:

• Muscle or joint strain. Kids might get chest pain from doing different or more strenuous-than-normal activities, says Dr. Zahka. With a muscle or joint strain, pain often comes with a certain movement or by pressing on a certain area.
• Inflammation. If your child’s ribs are tender adjacent to their breastbone, it may be a case of costochondritis (a type of inflammation). In adolescents aged 12 to 14, costochondritis accounts for up to 30% of chest pain complaints.

Pain from either of the above typically fades within a few days of rest and staying away from activities that aggravate the pain. Taking over-the-counter pain relievers can help reduce any discomfort.

When to be concerned about chest pain

Concerning pain related to the heart typically radiates out from within the chest, clarifies Dr. Zahka. Indications that chest pain in children may involve a more serious issue include pain that’s:

• Very intense and long-lasting.
• Triggered by physical activity.
• Accompanied by fever, dizziness, shortness of breath or fainting.

Bottom line? When in doubt, get chest pain checked out.

“It’s never wrong to consult a healthcare professional if you are worried about your child’s chest pain symptoms or heart health,” reassures Dr. Zahka. “A pediatrician or pediatric cardiologist can help get to the bottom of it.”