Adolescent chest pain.

Chest pain in adolescents rarely indicates serious organic pathology. Musculoskeletal disorders are the most common identifiable causes; psychogenic, respiratory and gastrointestinal disorders are also part of the differential diagnosis. Although cardiac disease is part of the differential diagnosis, it is very rare in this age group. Routine tests usually do not help establish a diagnosis and should be ordered only if indicated on the basis of the history and findings of the physical examination. Although most cases of chest pain are not caused by serious disease, the complaint should not be casually dismissed. An important role for primary care physicians is to provide support and adequate follow-up, because adolescent chest pain is often chronic.