Abstract
A 15-year-old African male presented with rheumatic heart disease after moving to the UK. He developed severe mitral and aortic valve disease and underwent replacement of both valves using mechanical prostheses. Compliance and clinic attendances were poor, but he remained well for 20 months when he began to experience chest pains with dizziness. Echocardiogram was unremarkable and while awaiting outpatient exercise testing he collapsed with severe left ventricular failure. ECG showed ischaemia and troponin was significantly elevated. Angiography showed mechanical left main stem compression caused by the mechanical aortic valve ring.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsSuggested Reading
Danduran MJ, Earing MG, Sheridan DC, Ewalt LA, Frommelt PC. Chest pain: characteristics of children/adolescents. Pediatr Cardiol. 2008;29(4):775–81.
Evangelista JA, Parsons M, Renneburg AK. Chest pain in children: diagnosis through history and physical examination. J Pediatr Health Care. 2000;14(1):3–8.
Friedman KG, Alexander ME. Chest pain and syncope in children: a practical approach to the diagnosis of cardiac disease. J Pediatr. 2013;163(3):896–901. e1–3.
Kane DA, Fulton DR, Saleeb S, Zhou J, Lock JE, Geggel RL. Needles in hay: chest pain as the presenting symptom in children with serious underlying cardiac pathology. Congenit Heart Dis. 2010;5(4):366–73.
Kliegman R, Nelson WE, editors. Nelson textbook of pediatrics. 19th ed. Philadelphia: Elsevier/Saunders; 2011.
Kyle WB, Macicek SL, Lindle KA, Kim JJ, Cannon BC. Limited utility of exercise stress tests in the evaluation of children with chest pain. Congenit Heart Dis. 2012;7(5):455–9.
Saleeb SF, Li WY, Warren SZ, Lock JE. Effectiveness of screening for life-threatening chest pain in children. Pediatrics. 2011;128(5):e1062–8.
Selbst SM, Ruddy RM, Clark BJ, Henretig FM, Santulli Jr T. Pediatric chest pain: a prospective study. Pediatrics. 1988;82(3):319–23.
Talner NS, Carboni MP. Chest pain in the adolescent and young adult. Cardiol Rev. 2000;8(1):49–56.
Verghese GR, Friedman KG, Rathod RH, Meiri A, Saleeb SF, Graham DA, et al. Resource utilization reduction for evaluation of chest pain in pediatrics using a novel Standardized Clinical Assessment and Management Plan (SCAMP). J Am Heart Assoc. 2012;1(2):ah3–e000349.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer-Verlag London
About this chapter
Cite this chapter
Theocharis, P., Magee, A.G. (2016). Chest Pain in Children: Not Always Benign. In: Magee, A., Till, J., Seale, A. (eds) Practical Pediatric Cardiology. Springer, London. https://doi.org/10.1007/978-1-4471-4183-9_6
Download citation
DOI: https://doi.org/10.1007/978-1-4471-4183-9_6
Publisher Name: Springer, London
Print ISBN: 978-1-4471-4182-2
Online ISBN: 978-1-4471-4183-9
eBook Packages: MedicineMedicine (R0)