Chest Pain

Chest pain is common in children and teenagers. 

In most cases, it is not serious and can usually be treated with simple pain killers at home.

If your child has any of the following:

If your child has chest pain and risk factors for a more serious heart condition including: 

  • congenital heart disease or previous heart surgery
  • previous Kawasaki disease
  • a cholesterol disorder
  • sickle cell disease
  • a history of using stimulating drugs like cocaine
  • Family history of arrhythmia, heart disease or sudden death

If your child has severe chest pain and none of the above risks:

  • has a very fast or irregular heart rate (palpitations)
  • has recently had an accident
  • Has had a collapse
  • Breathing very fast, too breathless to talk, eat or drink 
  • Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
  • Breathing that stops or pauses
  • Is pale, blue, mottled or feels unusually cold to touch
  • Difficult to wake up, very sleepy or confused
  • Has a fit (seizure)
  • Has a rash that does not disappear with pressure (the ‘Glass Test’)

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Has pain that travels to the neck or left shoulder and arm
  • Feels faint or dizzy when pain occurs
  • Chest pain during exercise 
  • Chest pain doesn’t go away with simple pain killers
  • Chest pain and cough
  • Chest pain and fever
  • Breathing a bit faster than normal or working a bit harder to breathe
  • Dry skin, lips or tongue
  • Not had a wee or wet nappy in last 8 hours
  • Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
  • Temperature less than 36°C 
  • Getting worse and I am still worried

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features

If your child has none of the above

If no red or amber signs, continue to provide self care at home with simple pain killers like paracetamol and ibuprofen. 

Watch them closely for any change and look out for any red or amber symptoms

If your child has a long term condition or disability and you are worried please contact your regular team or follow any plans that they have given you.

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

Common causes of chest pain in children:

Sometimes we do not know exactly what causes chest pain. Often it happens after coughing and straining of the muscles around the rib cage.

Costochondritis:

Pain over the front of the chest caused by inflammation where the sternum (breast bone) meets the ribs. It can worsen with a deep breath, coughing or if someone presses on the affected area.

What can I do?

  • A trial of regular Ibuprofen for 2-3 days can reduce the inflammation and pain. Please check the packaging for the dose.

Precordial catch syndrome:

Sharp pains in a small area of the chest when breathing in. Due to irritation of the nerves in between the ribs, this normally gets better by itself within a few minutes.

What can I do?

  • Most of the time no treatment is needed.
  • If it happens again take some slow deep breaths before the pain eases

Acid reflux:

The burning feeling in your chest caused by stomach acid travelling upwards towards the throat. Often there is no obvious reason why this happens but can sometimes be triggered by a virus irritating the stomach lining.

What can I do?

  • Eat smaller and more frequent meals
  • Stay upright for 30 minutes after eating
  • Avoid things which worsen the pain: these may include fizzy drinks, acidic, spicy or high fat foods
  • Avoid Ibuprofen because this can irritate the stomach lining further
  • Contact your doctor if symptoms persist.

Stress and anxiety:

Chest pain or tightness triggered when feeling stressed or worried. Often this can be related to a significant event in a child’s life, or sometimes there is no obvious cause.

What can I do?

  • Try to find ways to distract yourself from the discomfort. Click here for guidance
  • Speak to someone you trust about your worries
  • Visit your doctor if your symptoms persists

 

This guidance is written by healthcare professionals from across Hampshire, Dorset and the Isle of Wight.

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