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  • Select from over 100 symptoms to read more about managing your child's illness.

    Is Your Child Sick? TM


    Chest Pain

    Is this your child's symptom?

    • Pain or discomfort in the chest (front or back)
    • The chest includes from the top to the bottom of the rib cage

    If NOT, try one of these:


    Causes of Chest Pain

    • Muscle Overuse. Chest pain can follow hard sports (such as throwing a baseball). Lifting (such as weights) or upper body work (such as digging) can also cause it. This type of muscle soreness often increases with movement of the shoulders.
    • Muscle Cramps. Most brief chest pain lasting seconds to minutes is from muscle cramps. The ribs are separated by muscles. These fleeting pains can also be caused by a pinched nerve. These chest wall pains are harmless. Brief muscle cramps are also the most common cause of recurrent chest pains. The medical name is precordial catch syndrome.
    • Coughing. Chest pain commonly occurs with a hacking cough. Coughing can cause sore muscles in the chest wall, upper abdomen or diaphragm.
    • Asthma. Children with asthma often have a tight chest. They may refer to this as chest pain. They also get chest pain when they have lots of coughing.
    • Heartburn. Heartburn is due to reflux of stomach contents. It usually causes a burning pain under the lower sternum (breastbone).
    • Caffeine. A rapid and pounding heart beat may be reported as chest pain. Too much caffeine as found in energy drinks is a common cause. Drugs prescribed for ADHD also can cause a fast heartbeat. Illegal drugs, such as cocaine, can cause a high heart rate as well.
    • Chest Wall Injury. Blunt trauma usually just causes a bruised rib. Sometimes, it causes a rib fracture.
    • Heart Disease (Serious). Heart disease is hardly ever the cause of chest pain in children. Chest pain that only occurs with exercise could have a cardiac cause.
    • Pleurisy (Serious). Pleurisy is another problem of pneumonia. If the infection involves the lung's surface, that area of the chest will hurt.

    Pain Scale

    • Mild: your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
    • Moderate: the pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
    • Severe: the pain is very bad. It keeps your child from doing all normal activities.

    When to Call for Chest Pain

    When to Call for Chest Pain

    Call 911 Now

    • Severe trouble breathing (struggling for each breath, can barely speak or cry)
    • Passed out (fainted)
    • Bluish lips or face
    • Not moving or too weak to stand
    • You think your child has a life-threatening emergency

    Call Doctor or Seek Care Now

    • Your child has heart disease
    • Trouble breathing, but not severe
    • Taking a deep breath makes the pain worse
    • Heart is beating very rapidly
    • After a direct blow to the chest
    • Your child looks or acts very sick
    • You think your child needs to be seen, and the problem is urgent

    Call Doctor Within 24 Hours

    • Fever is present
    • Cause of chest pain is not clear. Exception: pain due to coughing, sore muscles, heartburn or other clear cause.
    • You think your child needs to be seen, but the problem is not urgent

    Call Doctor During Office Hours

    • Chest pains only occur with hard exercise (such as running)
    • Sore muscles last more than 7 days
    • Heartburn lasts more than 2 days on treatment
    • Chest pains are a frequent problem
    • You have other questions or concerns

    Self Care at Home

    • Normal chest pain from sore muscles
    • Normal chest pain from heartburn

    Call 911 Now

    • Severe trouble breathing (struggling for each breath, can barely speak or cry)
    • Passed out (fainted)
    • Bluish lips or face
    • Not moving or too weak to stand
    • You think your child has a life-threatening emergency

    Call Doctor or Seek Care Now

    • Your child has heart disease
    • Trouble breathing, but not severe
    • Taking a deep breath makes the pain worse
    • Heart is beating very rapidly
    • After a direct blow to the chest
    • Your child looks or acts very sick
    • You think your child needs to be seen, and the problem is urgent

    Call Doctor Within 24 Hours

    • Fever is present
    • Cause of chest pain is not clear. Exception: pain due to coughing, sore muscles, heartburn or other clear cause.
    • You think your child needs to be seen, but the problem is not urgent

    Call Doctor During Office Hours

    • Chest pains only occur with hard exercise (such as running)
    • Sore muscles last more than 7 days
    • Heartburn lasts more than 2 days on treatment
    • Chest pains are a frequent problem
    • You have other questions or concerns

    Self Care at Home

    • Normal chest pain from sore muscles
    • Normal chest pain from heartburn

    Care Advice

    Sore Muscle Pain Treatment

    1. What You Should Know About Mild Chest Pain:
      • Chest pains in children lasting for a few minutes are usually harmless. The pain can be caused by muscle cramps. They need no treatment.
      • Chest pains that last longer can be from hard work or sports. The shoulders are usually involved. Sore muscles can start soon after the event.
      • Here is some care advice that should help.
    2. Pain Medicine:
      • To help with the pain, give an acetaminophen product (such as Tylenol).
      • Another choice is an ibuprofen product (such as Advil).
      • Use as needed.
      • Continue this until 24 hours have passed without pain.
    3. Cold Pack for Pain:
      • For the first 2 days, use a cold pack to help with the pain.
      • You can also use ice wrapped in a wet cloth.
      • Put it on the sore muscles for 20 minutes, then as needed.
      • Caution: Avoid frostbite.
    4. Use Heat After 48 Hours:
      • If pain lasts over 2 days, put heat on the sore muscle.
      • Use a heat pack, heating pad or warm wet washcloth.
      • Do this for 10 minutes, then as needed.
      • Reason: Increase blood flow and improve healing.
      • Caution: Avoid burns.
      • A hot shower may also help.
    5. Stretching the Muscles:
      • Gentle stretching of the shoulders and chest wall may help.
      • Do sets of 10 twice daily.
      • This may prevent muscle cramps from coming back.
      • Stretching can be continued even during the chest pain. Do not do any exercises that increase the pain.
    6. What to Expect:
      • For sore muscles, the pain most often peaks on day 2.
      • It can last up to 6 or 7 days.
    7. Call Your Doctor If:
      • Pain becomes severe
      • Pain lasts over 7 days on treatment
      • You think your child needs to be seen
      • Your child becomes worse

    Heartburn (Reflux) Pain Treatment

    1. What You Should Know About Heartburn:
      • Heartburn is common.
      • It's due to stomach acid going up into the esophagus. The esophagus is the tube from the mouth to the stomach.
      • Heartburn causes a burning pain behind the lower part of the breastbone. It also causes a sour (acid) taste in the mouth and belching.
      • Here is some care advice that should help.
    2. Antacids:
      • Heartburn is usually easily treated. Give a liquid antacid by mouth (such as Mylanta or the store brand). No prescription is needed.
      • Dose: Give 1 to 2 tablespoons (15 - 30 mL).
      • If you don't have an antacid, use 2 to 3 ounces (60 - 90 mL) of milk.
      • For heartburn that keeps coming back, give an antacid 1 hour before meals. Also, give a dose at bedtime. Do this for a few days.
    3. Heartburn Prevention:
      • Do not eat too much at meals. This overfills the stomach.
      • Do not eat foods that make heartburn worse. Examples are chocolate, fatty foods, spicy foods, carbonated soda, and caffeine.
      • Do not bend over during the 3 hours after meals.
      • Do not wear tight clothing or belts around the waist.
    4. What to Expect:
      • Most often, heartburn goes away with treatment.
      • But, heartburn also tends to come back. So, preventive measures are important.
    5. Call Your Doctor If:
      • Heartburn doesn't go away after 2 days of treatment
      • You think your child needs to be seen
      • Your child becomes worse

    And remember, contact your doctor if your child develops any of the 'Call Your Doctor' symptoms.

    Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

    Copyright 2000-2019 Schmitt Pediatric Guidelines LLC.