In pediatric patients presenting to the emergency department with chest pain, only 15% have an actual cardiac etiology, emphasizing that thorough history and physical examination are usually sufficient for evaluation.
Supports conservative evaluation in pediatric ED chest pain; leaves open need for validated risk-stratification tools in prospective studies.
This study intends to establish the etiology of chest pain in the pediatric population, to determine the causal relationship between a cardiac problem and chest pain in acutely sick children, and to provide a systematic approach to the management of these patients. The charts of 134 patients, up to 19 years of age, seen in the emergency department (ED) of Children's Hospital of Wisconsin (CHW) with the primary diagnosis of "chest pain" during a five-year period were reviewed. In 15% of these patients, a relationship was established between chest pain and actual cardiac disease. A thorough history and physical examination are the diagnostic "keys" in evaluating pediatric patients with chest pain; laboratory tests are often helpful when indicated by the history and physical examination. In the majority of the cases, reassurance is all that is required; occasionally, pharmacologic treatment is recommended. Hospitalization is rarely necessary.
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ZAVARAS-ANGELIDOU et al. (1992) studied this question.
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