Analysis of the clinical features of chest pain in adolescents and children in the Shihezi area of Xinjiang

Objective To investigate the causes and clinical characteristics of chest pain in adolescents aged 8-17 years in the Shihezi area of Xinjiang, and to provide reference for clinical diagnosis and treatment. Methods A retrospective analysis was conducted on 243 children aged 8-17 years who presented with non-traumatic chest pain at the Pediatric Emergency and Outpatient Department of the First Affiliated Hospital of Shihezi University from January 2023 to December 2024. Clinical data, including medical history, physical examination findings, laboratory tests, and imaging studies, were collected. Continuous variables were compared using one-way analysis of variance or the Kruskal–Wallis test, and categorical variables were compared using the chi-square test or Fisher's exact test, as appropriate. An exploratory multivariable logistic regression analysis was performed to assess factors associated with cardiac chest pain classification. Results Non-cardiac causes were the most common reason for chest pain (47.7%), followed by cardiac causes (20.6%), while the cause remained undetermined in 31.7% of the cases. Work-rest relationship, NRS score, shortness of breath, and palpitations differed significantly among the three groups, whereas chest pain duration, syncope, and fatigue did not. Sex distribution showed a borderline difference among groups ( P = 0.050). Myocardial biomarkers were higher in the cardiac group; however, these findings should be interpreted cautiously because these biomarkers may have contributed to etiological classification. The non-cardiac group showed the highest abnormal rates in chest x-ray and pulmonary function tests. In exploratory multivariable analysis, NLR, HDL-C, CRP, and LDH were associated with cardiac chest pain classification, but the model was limited by a low events-per-variable ratio. Conclusion Clinicians should emphasize detailed history taking and physical examination and select auxiliary tests according to clinical risk features. Chest x-ray and pulmonary function abnormalities were more frequent in patients with respiratory diagnoses, whereas abnormal electrocardiography and elevated myocardial biomarkers were more common in patients classified as having cardiac chest pain. However, these findings indicate associations rather than diagnostic accuracy.