Kids and teens will sometimes have chest pain. It happens more often than you think. We see at least 4-5 kids per week in the Emergency Department for complaints of chest pain. When it happens, parents sometimes freak out. Is it a heart attack, like happened to Uncle Frim? Even worse, some kids will even say “My heart hurts” when they mean ”chest pain.” Talk about causing a freak-out!
Teenagers have chest pain the most. As they grow, they often have aches and sharp pains in their rib cages. Teens worry about that more because they are already worried about what is happening in their developing bodies- new shapes and sizes, new emotions, and new aches and pains.
Here is the good news: chest pain in kids is rarely a heart problem. Lung problems are unusual too. The vast majority of aches and pains in the chest are in the chest wall, the ribs and ligaments and cartilage that form the rib cage. When kids exert their chest wall with coughing or exercising or injury, those parts of the rib cage get sore, just like any other injury. Sometimes in teenagers a “hot spot” in the chest wall just seems to happen out of the blue.
When should you really worry? The warning signs for lung problems are more obvious: coughing and shortness of breath, fever and fatigue. Heart problems in kids are rare, and usually don’t cause sudden pain, like in adults. Heart issues tend to start with progressive weakness, shortness of breath, changes in weight (weight loss or weight gain). We also pay attention to kids who faint or have deep chest pain when they exercise. Those kids need to get seen right away. Finally, some kids have a history of family members who died suddenly at an early age (younger than 40). Those families can have a rare inherited problem with cardiac rhythm, and the kids in the family can have it.
However, if your teen complains of sharp chest pain that is worse when you press on the pain site, hurts more with a deep breath (stretching that hot spot), but is otherwise awake and alert and well and active, don’t panic. Treat with plenty of ibuprofen, cut back the exercise and stress to let things heal, and it should be gone in about four days. The vast majority of teens and kids have good hearts. In more ways than one!