Key result
Atypical chest pain in athletes is commonly caused by musculoskeletal, gastrointestinal, respiratory, or cardiac conditions, with return-to-play ranging from immediate to at least 6 months.
This review highlights the diverse non-ischemic causes of chest pain in athletes and emphasizes tailored return-to-play strategies based on the specific etiology.
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Supports etiology-specific evaluation of atypical chest pain in athletes; leaves open prospective validation of return-to-play timelines.
Initial management of chest pain in athletes always should involve assessment for serious, life-threatening causes, such as myocardial infarction. However, atypical chest pain, or chest pain not due to myocardial ischaemia, is a common presentation in the athletic population. This review looks at the possible causes of atypical chest pain in athletes, focusing upon conditions that are more common in athletes than the general population or that have a link to exercise. Causes can be grouped due to the system involved (musculoskeletal, gastrointestinal, respiratory, cardiac) with more common causes including rib stress fractures, costochondritis, muscle strain, gastroesophageal reflux, and exercise-induced asthma. Psychogenic causes can be common in children/adolescents. Return to play is discussed, with some conditions such as myocarditis warranting a long (at least 6 months) absence from training, whereas others such as precordial catch require nothing more than reassurance.
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Sik et al. (2009) conducted a review in Atypical chest pain. Atypical chest pain in athletes is commonly caused by musculoskeletal, gastrointestinal, respiratory, or cardiac conditions, with return-to-play ranging from immediate to at least 6 months.
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