Most causes of chest pain in children are benign and self-limiting, such as musculoskeletal and gastrointestinal conditions. It is rarely a symptom of a serious underlying condition.

Chest pain is not uncommon in children. It is common in emergency and outpatient settings and accounts for 6 in every 1,000 visits to the emergency room.

Most of these cases are benign and do not stem from heart problems.

This article explores common conditions that cause chest pain in children and when chest pain can be a sign of something more serious.

Research from 2020 estimates that around 80–85% of pediatric chest pain cases are not serious and do not have a known cause, which experts describe as “idiopathic.” These cases may also be described as noncardiac chest pain.

In a 2020 study analyzing chest pain in children in Iran, nearly half have an unknown cause.

A 2021 study similarly concluded that idiopathic chest pain was the most common cause of chest pain in children in China.

These results are similar to a 2022 study that found the most common cause of chest pain among children in Japan was idiopathic.

Other related symptoms

Some children may describe their chest pain as a sharp, stabbing pain during rest and exercise. The pain may last seconds to minutes. Episodes happen now and then and get better on their own.

Treatment

Experts do not recommend medications for idiopathic chest pain. Gentle massage and heat may improve symptoms.

In the studies above, musculoskeletal-related concerns were the second most common cause of chest pain in children. However, it was the leading cause of pediatric chest pain in a 2022 study.

Some musculoskeletal conditions that may cause chest pain include:

Other related symptoms

The following symptoms may accompany musculoskeletal-related chest pain:

  • chest wall tenderness
  • pain aggravated by breathing
  • pain upon movement (muscle strain)
  • tenderness when touching the costochondral junction, which is the connection between the ribs and supporting cartilage

Treatment

Doctors recommend rest for exercise-related pain. Parents and caregivers may also give ibuprofen (Advil) for pain relief and apply heat and massage.

Doctors may also prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) or antibiotics when necessary.

Gastrointestinal problems are also common causes of chest pain in children. Gastrointestinal diseases that cause chest pain in children include:

Other related symptoms

Some of the symptoms of chest pain associated with gastrointestinal causes include:

Treatment

A doctor may prescribe proton pump inhibitors to treat acid reflux. Acid reflux is one of the most common causes of noncardiac chest pain.

Chest pain is one of the most common symptoms of pulmonary diseases. According to a 2015 study, respiratory diseases followed idiopathic causes as the leading causes of pediatric chest pain.

Respiratory diseases that may cause chest pain include:

Other related symptoms

Other common symptoms include shortness of breath and cough.

Treatment

Some lung conditions resolve on their own. Others may require antibiotics, other medications, or interventions.

Less than 5% of chest pain cases in children are due to heart-related conditions. When a heart condition is the cause, it most commonly occurs in adolescents ages 15–18 years.

Causes of cardiac chest pain include:

The most common inflammatory diseases causing chest pain are myocarditis and pericarditis. Although rare, children and teens may have pericarditis or myocarditis after receiving the COVID-19 vaccine.

Other related symptoms

Chest tightness and discomfort are the most common symptoms of cardiac-related chest pain. Other signs and symptoms may include:

Treatment

Doctors may prescribe medications to control and relieve chest pain. They may also prescribe other medications to manage it long term.

Some of these medications may include anticoagulant medications and beta-blockers. However, these treatments are more common in adults.

A caregiver should seek medical attention if the child with chest pain:

  • has heart disease
  • shows breathing difficulty
  • experiences pain with deep breathing
  • has a rapid heartbeat
  • looks pale and sick
  • experienced a direct blow to the chest

Since there are many potential causes of chest pain in children, doctors use a variety of methods to diagnose the cause. A doctor will likely take the child’s medical history, perform a physical examination, and order tests.

The doctor may ask about the following:

  • site of pain
  • severity of pain
  • how long the pain lasts
  • associated symptoms
  • triggers

They may also ask about any family history of cardiac-related conditions, recent trauma, and medication history.

Some imaging tests a doctor may order include:

  • chest X-ray
  • electrocardiogram (EKG)
  • echocardiogram

Below are some frequently asked questions about chest pain in children.

What would cause a child’s chest to hurt?

The most common cause of chest pain in children is idiopathic (unknown cause). Other potential causes are:

  • musculoskeletal
  • gastrointestinal
  • respiratory
  • psychological
  • cardiac

How do I know if my child’s chest pain is serious?

Chest pain is considered serious when it occurs alongside these symptoms:

  • severe trouble breathing
  • fainting
  • extreme weakness
  • bluish lips or face

If a child has chest pain and any of these symptoms, seek emergency medical attention.

Is it normal for a child to have chest pain?

Chest pain is a fairly common complaint among children. However, a caregiver should consult a doctor if the child has any other symptoms that accompany the chest pain.

Can children have chest pain due to a heart attack?

Children can experience chest pain from heart problems such as a heart attack, but this is rare. Heart problems account for less than 5% of chest pain in children.

Read more about heart attacks and children.

Chest pain is a common complaint among children. Many parents and caregivers may associate it with a heart condition, but cardiac-related causes are uncommon.

The most common cause of chest pain in children is idiopathic (unknown cause).

Other potential causes include musculoskeletal, gastrointestinal, and respiratory issues. It is essential to consult a doctor if a child is experiencing chest pain to learn its underlying cause and the best course of treatment.

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