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Usually Benign Cardiac Symptoms in Children

Chest Pain in Children

Unlike in adults, chest pain in children is rarely caused by a heart problem. One of the most common reason for chest pain in kids is chest muscle soreness. This can be caused by a hacking cough, strenuous exercise, heavy lifting or other activities that would strain the muscles of the chest wall, upper abdomen or diaphragm. It is usually characterized by worsening of the pain with movement of the shoulders and chest or with deep breathing. This pain usually resolves after a week or so with rest and anti-inflammatory medications such as ibuprofen (i.e. Advil or Motrin)

Another very common cause of chest pain in children is that associated with stomach acid reflux. That is, the acids of the stomach back up into the esophagus (food pipe) and cause irritation and pain. This pain occurs especially after eating spicy or greasy foods but may also occur at other times. Stress and anxiety will make this kind of pain worse. Also, alcohol intake and some drugs can also make it worse. This kind of pain usually feels better with antacids. Stress reduction and cessation of alcohol/drug intake also helps.

Chest pain in children may be related to a heart problem if it is associated with heart palpitations, lightheaded-ness, or passing out in which case you should contact your care provider immediately. You should also contact your provider if the pain occurs during active exercise. Usually, a thorough evaluation which may include an electrocardiogram (EKG) and chest X-ray will help your physician rule out a heart problem as the cause for your child’s chest pain. In the rare cases when this cannot be ruled out, a referral to a pediatric cardiologist may be necessary.

The Innocent Heart Murmur

Heart murmurs are sounds produced by the flow of blood through your child’s heart. They are recognized by your pediatrician while listening to your child’s heart with a stethoscope. He or she can usually tell whether a murmur is harmless or indicates a heart condition.

If your pediatrician says your child has an innocent heart murmur, it may seem alarming. An innocent murmur, however, is just what the name implies — innocent. It means your child’s heart is normal. He or she will need no medications and will have no cardiac symptoms. Your child can be as active as any other well child should be.

Innocent murmurs are very common, occurring in over half of children at some point in their childhood. They may also disappear and then reappear at various times. They are usually easier to hear when your heart is stimulated, such as with a fever, after drinking caffeinated products, or after exercise. Most, but not all innocent murmurs disappear for good by the time a child becomes an adult. Regardless of whether the innocent murmur is present or gone, however, your child’s heart is normal.

Sometimes heart murmurs are hard to interpret. Your pediatrician may need to consult a pediatric cardiologist if he or she is having difficulty in deciding whether a murmur is innocent or not. In addition to an examination other tests may be necessary to evaluate your child’s heart. The pediatric cardiologist can explain these tests and their results to you.

The American Heart Association has collected several questions and answers for Patients with Innocent Murmurs.