scholarly journals Etiology and treatment of chest pain in children and adolescents

2020 ◽  
Vol 63 (7) ◽  
pp. 382-389
Author(s):  
Kyung Lim Yoon
Keyword(s):  
Chest Pain ◽  
Children And Adolescents ◽  
Cardiac Diseases ◽  
Common Symptom ◽  
Common Causes ◽  
Pediatric Chest ◽  
Life Threatening ◽  
Red Flag ◽  
Benign Nature ◽  
Complete History

Chest pain is a very common symptom in pediatric patients. Although children with chest pain are relatively unlikely to be suffering from significant cardiac diseases, it is important not to overlook life-threatening diseases. Complete history taking and physical examination––which involves identifying the duration of pain, onset, character, associated symptoms, and aggravating factors––are extremely important. The most common causes of pediatric chest pain are idiopathic and musculoskeletal, while less than 3% of cases are of cardiac origin. Recent studies indicate that chest pain resulted from psychosomatic disorders increases in non-cardiac chest pain in children and adolescents. The reassurance of the benign nature of chest pain is enough in most cases of non-cardiac chest pain in children and adolescents. When echocardiography is performed on patients with exertional chest pain, it is important to confirm the origin of coronary artery to exclude any coronary anomaly. Exertional chest pain, combined syncope, and symptoms of myocardial ischemia should raise the suspicion of significant cardiac diseases. When the chest pain is accompanied by red flag signs, physicians must refer the patients to a pediatric cardiologist.

Upper Gastrointestinal Bleeding in Children and Adolescents

PEDIATRICS ◽  
1979 ◽  
Vol 63 (3) ◽  
pp. 408-413
Author(s):  
Kenneth Cox ◽  
Marvin E. Ament
Keyword(s):  
Children And Adolescents ◽  
Signs And Symptoms ◽  
Gastric Ulcers ◽  
Coagulation Disorder ◽  
Duodenal Ulcers ◽  
Male Predominance ◽  
Transfusion Requirements ◽  
Common Causes ◽  
Life Threatening ◽  
Upper Gastrointestinal

This is a retrospective study of upper gastrointestinal testinal hemorrhage in 68 children and adolescents who were less than 19 years old. In descending order of frequency, the five most common causes were duodenal ulcers, gastric ulcers, esophagitis, gastritis, and esophageal varices. There was male predominance in all diagnoses except gastric ulcers and gastritis. Signs and symptoms correlated poorly with the source of bleeding. Endoscopy was the most reliable method of identifying the bleeding site. Mortality correlated with the following: (1) initial hematocrit or hemoglobin level of <20% or <7 gm/100 ml, respectively, (2) transfusion requirements of >85 ml/kg of blood without surgical intervention, (3) failure to identify the source of bleeding, (4) presence of a coagulation disorder, and (5) coexistence of another life-threatening disease.

scholarly journals Mellkasi panasz ritka oka

2016 ◽  
Vol 157 (36) ◽  
pp. 1445-1448
Author(s):  
Beáta Bodócsi ◽  
István Koncz ◽  
Zsigmond Hum ◽  
Orsolya Serfőző ◽  
József Pap-Szekeres ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Thoracic Aorta ◽  
Common Symptom ◽  
Main Task ◽  
Chest Computed Tomography ◽  
Coronary Syndrome ◽  
Life Threatening ◽  
Pulmonary Embolization

Chest pain is a common symptom in patients who visit Emergency Departments. The main task is to exclude life-threatening diseases such as acute coronary syndrome, pulmonary embolization and dissection of thoracic aorta. The authors present the history of a patient, who had an intense chest pain for 7 hours. In accordance with the diagnostic algorithm of chest pain, ECG, blood collection, chest X-ray and chest computed tomography angiography were performed. Acute coronary syndrome, pulmonary embolization and dissection of the thoracic aorta were excluded, however, chest computed tomography CT revealed a huge hiatal hernia as an incidental finding. An emergency surgical repair was performed and the patient recovered without any complications. The authors emphasize that the diagnostic algorithms focus on the confirmation or rejection of possible life threatening diseases in case of chest pain. However, it should be kept in mind that rarer causes may occur, which may require involvement of the relevant disciplines and multidisciplinary thinking. Orv. Hetil., 2016, 157(36), 1445–1448.

Chest Pain

2018 ◽  
pp. 290-294
Author(s):  
Jennifer Bellis
Keyword(s):  
Chest Pain ◽  
Diagnostic Procedures ◽  
Diagnosis And Treatment ◽  
X Rays ◽  
Common Causes ◽  
Pediatric Chest

This chapter reviews the evaluation, workup, diagnosis and treatment of chest pain in a child. Additionally, it reviews common causes of pediatric chest pain as well as important components of the history and physical that may indicate a more serious cause of pediatric chest pain. These patients may require further diagnostic procedures or referral to a subspecialist for further evaluation. Finally, it discusses the role of electrocardiogram and chest X-rays in the workup of pediatric chest pain. In general, most adolescent occurrence of chest pain has a benign etiology, commonly with a musculoskeletal cause. Absent other abnormal findings, these patients often require only a minimal workup.

scholarly journals Overview of Juvenile Idiopathic Arthritis

2020 ◽  
Vol 14 (1) ◽  
pp. 101-109
Author(s):  
Nadine Saad ◽  
Karen Onel
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Children And Adolescents ◽  
Clinical Features ◽  
Medical Management ◽  
Joint Pain ◽  
Joint Inflammation ◽  
Chronic Arthritis ◽  
Common Symptom ◽  
Common Causes ◽  
Work Up

Joint pain is a common symptom in children and adolescents. While there are many causes of joint pain in children, most of these are acute or not related to underlying joint inflammation. Chronic arthritis, however, can be one of the reasons behind the joint pain. The most common causes of chronic arthritis in children are categorized under juvenile idiopathic arthritis (JIA). The purpose of this review is to highlight the most important clinical features, work-up, and medical management of the different subtypes of JIA.

Pediatric Chest Pain: A Prospective Study

PEDIATRICS ◽  
1988 ◽  
Vol 82 (3) ◽  
pp. 319-323 ◽  
Author(s):  
Steven M. Selbst ◽  
Richard M. Ruddy ◽  
B. J. Clark ◽  
Frederick M. Henretig ◽  
Thomas Santulli
Keyword(s):  
Chest Pain ◽  
Age Groups ◽  
Acute Onset ◽  
Psychogenic Pain ◽  
Idiopathic Pain ◽  
Common Causes ◽  
Pediatric Chest ◽  
History Of ◽  
A Prospective Study ◽  
Ecg Abnormalities

Previous studies of childhood chest pain have been retrospective or considered only limited age groups or referred patients. In this study, all children who were admitted to the emergency department with chest pain were evaluated prospectively. Patients with ill-defined chest pain had ECGs and echocardiograms performed. A total of 407 children were evaluated. The most common causes of the pain were idiopathic (21%) and musculoskeletal (15%). Cardiac problems were found in 4%. Chest pain was acute (of <48 hours' duration) in 43% and chronic (of >6 months' duration) in 7%. Pain caused 30% of children to stay out of school and 31% to awaken from sleep. Chest wall tenderness was the most common abnormality. ECGs were obtained in 47%; results of 31/191 were abnormal but only 4/191 ECG abnormalities were related to the diagnosis. Echocardiograms were obtained in 34%; results of 17/139 were abnormal (12/139 showed mitral valve prolapse). Young children are more likely to have cardiorespiratory problems; children older than 12 years of age are more likely to have psychogenic pain. The description and location of the pain and the patient's sex are not related to the diagnosis. Nonorganic disease is related to a family history of heart disease or chest pain or having chronic pain. Organic disease is related to pain of acute onset, abnormal physical examination results, pain that awakens the child from sleep, and the presence of fever. Laboratory tests are rarely helpful in evaluating children with chest pain. Chest pain in children is usually benign. Psychogenic pain and idiopathic pain are less common than previously believed.

scholarly journals Symptomatic Pericardial Cyst: An Atypical Case of Pleuritic Chest Pain

2019 ◽  
Vol 3 (3) ◽  
pp. 199-201 ◽  
Author(s):  
T. Douglas Sallade ◽  
Chadd Kraus ◽  
Lisa Hoffman
Keyword(s):  
Chest Pain ◽  
Mediastinal Mass ◽  
Emergency Physicians ◽  
Pleuritic Chest Pain ◽  
Atypical Chest Pain ◽  
Coronary Syndrome ◽  
Pericardial Cyst ◽  
Common Causes ◽  
Life Threatening ◽  
Pericardial Cysts

Pericardial cysts were first described in 1837 as diverticula extending from the pericardium. They are rare and frequently asymptomatic. Symptomatic presentations may be similar to more common causes of chest pain or dyspnea such as acute coronary syndrome or pulmonary embolism. Emergency physicians should consider mediastinal mass, and in this case pericardial cyst, in the differential diagnosis of chest pain because of the risk for tamponade, sudden cardiac death, or other life-threatening complications. Here, we describe a novel presentation of a pericardial cyst presenting as atypical chest pain.

scholarly journals Unusual Cause for Pediatric Chest Pain: MDCT Evaluation of Single Coronary Artery

2014 ◽  
Vol 3 (2) ◽  
pp. 81-84
Author(s):  
K Gangadhar
Keyword(s):  
Congenital Anomaly ◽  
Chest Pain ◽  
Coronary Artery ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Single Coronary Artery ◽  
Rare Congenital Anomaly ◽  
Pediatric Chest ◽  
Life Threatening ◽  
Threatening Situation

Single coronary artery (SCA) is a rare congenital anomaly in which the entire coronary system arises from a solitary ostium. Anomalies of the coronary arteries are rare conditions that are often asymptomatic. However, if perfusion by the coronary artery is impaired, this anomaly can lead to a life-threatening situation, such as myocardial ischemia or infarction, and sudden cardiac death. We report a case of single coronary artery in a six year old girl who presented with acute chest pain.DOI: http://dx.doi.org/10.3126/njr.v3i2.9616    Nepalese Journal of Radiology Vol.3(2)July-Dec, 2013: 81-84 

The tactics of managing children and adolescents when twisting the uterine appendages from the position of international standards

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 39-41
Author(s):  
Zalina K. Batyrova ◽  
Zaira K. Kumykova ◽  
Elena V. Uvarova ◽  
Vladimir D. Chuprynin ◽  
Natalya A. Buralkina ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Ovarian Tissue ◽  
Standard Of Care ◽  
Lymphatic Drainage ◽  
International Standards ◽  
Delivery Of Care ◽  
National Medical ◽  
Treatment Standard ◽  
Common Causes ◽  
Adolescent Gynecology

Background. Adnexal torsion (AT) takes fifth place among all emergency gynecological conditions. Suspicion of AT requires immediate diagnosis and urgent surgical treatment. The most common causes of AT are various volumetric formations, such as functional or dermoid ovarian cysts, contributing to an increase in its volume and/or anomalies in the development of the ligamentous apparatus. Timely diagnosis and detorsion contributes to the full restoration of impaired venous outflow and lymphatic drainage of the ovarian tissue, preventing the development of severe ischemia and necrosis. Over the past few decades, a surgical organ-preserving approach in managing patients with AT has been the gold standard of care. Materials and methods. The article describes the results of a retrospective study of cases of AT in children and adolescents treated at the Department of Pediatric and adolescent gynecology Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology with an assessment of the clinical and anamnestic features of this cohort of patients and the choice of therapeutic tactics. Conclusion. A multidisciplinary approach is critical to optimizing the delivery of care in cases of AT, including minimally invasive detorsion and preserving the functionality of the ovary as a treatment standard that should be used in the management of children and adolescents.

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