Pediatric Chest Pain Flashcards¶
Anki-compatible flashcards for Pediatric Chest Pain board review.
Q: What is the most common cause of chest pain in children? A: Musculoskeletal (costochondritis, muscle strain) - accounts for 30-50% of cases Tags: chest-pain, etiology, high-yield
Q: What percentage of pediatric chest pain is cardiac in origin? A: <5% (most chest pain in children is NOT cardiac) Tags: chest-pain, etiology, high-yield
Q: What are red flags for cardiac chest pain in children? A: Exertional pain, syncope, palpitations, family history of sudden death, associated diaphoresis, abnormal exam, abnormal ECG Tags: chest-pain, red-flags, high-yield
Q: What is costochondritis and how does it present? A: Inflammation of costochondral junctions; sharp pain reproduced by palpation of chest wall; no swelling (if swelling = Tietze syndrome) Tags: chest-pain, musculoskeletal
Q: What cardiac conditions can cause chest pain in children? A: Pericarditis, myocarditis, coronary anomalies (AAOCA), HCM, aortic stenosis, aortic dissection, arrhythmias, Kawasaki-related coronary issues Tags: chest-pain, cardiac-causes
Q: What is precordial catch syndrome (Texidor's twinge)? A: Sudden, sharp, localized chest pain lasting seconds to minutes; occurs at rest; relieved by shallow breathing or posture change; benign Tags: chest-pain, benign, precordial-catch
Q: What GI condition commonly presents as chest pain in children? A: Gastroesophageal reflux (GERD) - burning substernal pain, worse after meals or lying down Tags: chest-pain, gi-causes
Q: What pulmonary conditions cause chest pain in children? A: Asthma, pneumonia, pleural effusion, pneumothorax, pulmonary embolism (rare in children) Tags: chest-pain, pulmonary-causes
Q: What ECG findings are concerning in a child with chest pain? A: ST changes, T wave inversions, Q waves, prolonged QTc, pre-excitation, arrhythmia, ventricular hypertrophy Tags: chest-pain, ecg, workup
Q: When is echo indicated for pediatric chest pain? A: Abnormal exam (murmur, rub, abnormal pulses), abnormal ECG, exertional symptoms, syncope, family history concerning for cardiomyopathy or sudden death Tags: chest-pain, workup, echo
Q: What is the classic presentation of pericarditis chest pain? A: Sharp, pleuritic pain improved by leaning forward, worse lying flat; may have friction rub; often preceded by viral illness Tags: chest-pain, pericarditis
Q: What is the psychogenic component of chest pain in adolescents? A: Anxiety-related chest pain is common (10-20%); presents with hyperventilation, paresthesias, difficulty taking deep breath; normal exam Tags: chest-pain, anxiety, psychogenic
Q: What workup is needed for typical musculoskeletal chest pain with normal exam? A: None - reassurance is appropriate. ECG only if any red flags present. Tags: chest-pain, workup, high-yield
Q: How do you counsel families about benign chest pain? A: "Chest pain in children is rarely from the heart. Your child's exam is normal, and this is likely from muscles or growing pains. No restrictions needed." Tags: chest-pain, counseling
Q: What finding on exam suggests costochondritis? A: Reproducible tenderness on palpation of costochondral junctions (where ribs meet cartilage) Tags: chest-pain, physical-exam, costochondritis