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Symptoms and Signs – Differential Diagnosis of Chest Pain in Children
MUSCULOSKELETAL (COMMON)
• Trauma (accidental, abuse)
• Exercise, overuse injury (strain, bursitis)
• Costochondritis (Tietze’s syndrome)
• Herpes zoster (cutaneous)
• Pleurodynia
• Fibrositis
• Slipping rib
• Sickle cell anemia vaso-occlusive crisis
• Osteomyelitis (rare)
• Primary or metastatic tumor (rare)
PULMONARY (COMMON)
• Pneumonia
• Pleurisy
• Asthma
• Chronic cough
• Pneumothorax
• Infarction (sickle cell anemia)
• Foreign body
• Embolism (rare)
• Pulmonary hypertension (rare)
• Tumor (rare)
GASTROINTESTINAL (LESS COMMON)
• Esophagitis (gastroesophageal reflux)
• Esophageal foreign body
• Esophageal spasm
• Cholecystitis
• Subdiaphragmatic abscess
• Perihepatitis (Fitz-Hugh–Curtis syndrome)
• Peptic ulcer disease
CARDIAC (LESS COMMON)
• Pericarditis
• Postpericardiotomy syndrome
• Endocarditis
• Mitral valve prolapse
• Aortic or subaortic stenosis
• Arrhythmias
• Marfan syndrome (dissecting aortic aneurysm)
• Anomalous coronary artery
• Kawasaki’s disease
• Cocaine, sympathomimetic ingestion
• Angina (familial hypercholesterolemia)
IDIOPATHIC (COMMON)
• Anxiety, hyperventilation
• Panic disorder
OTHER (LESS COMMON)
• Spinal cord or nerve root compression
• Breast-related pathologic condition
• Castleman’s disease (lymph node neoplasm)
MUSCULOSKELETAL (COMMON)
• Trauma (accidental, abuse)
• Exercise, overuse injury (strain, bursitis)
• Costochondritis (Tietze’s syndrome)
• Herpes zoster (cutaneous)
• Pleurodynia
• Fibrositis
• Slipping rib
• Sickle cell anemia vaso-occlusive crisis
• Osteomyelitis (rare)
• Primary or metastatic tumor (rare)
PULMONARY (COMMON)
• Pneumonia
• Pleurisy
• Asthma
• Chronic cough
• Pneumothorax
• Infarction (sickle cell anemia)
• Foreign body
• Embolism (rare)
• Pulmonary hypertension (rare)
• Tumor (rare)
GASTROINTESTINAL (LESS COMMON)
• Esophagitis (gastroesophageal reflux)
• Esophageal foreign body
• Esophageal spasm
• Cholecystitis
• Subdiaphragmatic abscess
• Perihepatitis (Fitz-Hugh–Curtis syndrome)
• Peptic ulcer disease
CARDIAC (LESS COMMON)
• Pericarditis
• Postpericardiotomy syndrome
• Endocarditis
• Mitral valve prolapse
• Aortic or subaortic stenosis
• Arrhythmias
• Marfan syndrome (dissecting aortic aneurysm)
• Anomalous coronary artery
• Kawasaki’s disease
• Cocaine, sympathomimetic ingestion
• Angina (familial hypercholesterolemia)
IDIOPATHIC (COMMON)
• Anxiety, hyperventilation
• Panic disorder
OTHER (LESS COMMON)
• Spinal cord or nerve root compression
• Breast-related pathologic condition
• Castleman’s disease (lymph node neoplasm)
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