Review of 180 episodes of chest pain in 134 children.

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.