Abstract
Chest pain is a common complaint in children, adolescents, and adults. Although, most children with chest pain do not present in severe distress with serious underlying condition, all need a very careful evaluation to rule of such a disorder. Chest pain in a child can cause significant anxiety for the parents. In adults, chest pain is often a sign of serious underlying cardiac or noncardiac disease, and a prompt and thorough evaluation is important before making a diagnosis of functional chest pain. However, when a complete medical evaluation reveals no serious cause, persistence of chest pain can still be a source for ongoing concern and anxiety. A thorough history and physical examination are key elements of a diagnostic evaluation. In addition to organic causes of chest pain, psychological factors must be carefully considered in all patients who present with chest pain. This chapter reviews diagnostic approach and psychological factors in pediatric and adult chest pain.
Keywords
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Eslick GD. Epidemiology and risk factors of pediatric chest pain: a systematic review. Pediatr Clin North Am. 2010;57:1211–19.
Eslick GD. Classification, natural history, epidemiology, and risk factors of noncardiac chest pain. Dis Mon. 2008;54:593–603.
Driscoll DJ, Glicklich LB, Gallen WJ. Chest pain in children: a prospective study. Pediatrics. 1976;57:648–51.
Hambrook JT, Kimball TR, Khoury P, et al. Disparities exist in the emergency department evaluation of pediatric chest pain. Congenit Heart Dis. 2010;5:285–91.
Selbst SM, Ruddy RM, Clark BJ. Chest pain in children follow-up of patients previously reported. Clin Pediatr (Phila). 1990;297:374–7.
Ruigomez A, Rodriguez LA, Wallander MA, et al. Chest pain in general: incidence, comorbidity, and mortality. Fam Pract. 2007;8:51.
Buntix F, Knockaert D, Bruyninckx R, et al. Chest pain in general practice or in the hospital emergency room. Fam Pract. 2001;18(6):586–9.
Selbst SA. Approach to the child with chest pain. Pediatr Clin North Am. 2010;57:1221–34.
Cava JR, Sayger PL. Chest pain in children and adolescents. Pediatr Clin North Am. 2004;51:1553–68.
Lee TH. Chest pain and palpitations. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, editors. Harrison’s principles of internal medicine. 16th ed. New York: McGraw Hill Medical; 2005. p. 76–8.
Richter JE. Overview of diagnostic testing for chest pain of unknown origin. Am J Med. 1992;92(suppl 5A):41S–5S.
Bass C, Wade C. Chest pain with normal coronary arteries: a comparative study of psychiatric and social morbidity. Psychol Med. 1984;14:51–61.
McDonnell CJ, White KS. Assessment and treatment of psychological factors in pediatric chest pain. Pediatr Clin North Am. 2010;57:1235–60.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Washington: American Psychiatric Association; 2000.
Martin AL, McGrath PA, Brown SC, et al. Anxiety sensitivity, fear of pain and pain-related disability in children and adolescents with chronic pain. Pain Res Manag. 2007;12:267–72.
Delamater A, Jent JF. Cardiovascular disease. In: Roberts MC, Steele RG, editors. Handbook of pediatric psychology. New York: Guilford Press; 2009. p. 381–91.
Filho AS, Maciel BC, Martin-Santos R, et al. Does the association between mitral valve prolapse and panic disorder really exist? Prim Care Companion J Clin Psychiatry. 2008;10:38–47.
Asnes RS, Santulli R, Bemporad JR. Psychogenic chest pain in children. Clin Pediatr (Phila). 1981;20:788–91.
Gilleland J, Blount RL, Campbell RM, et al. Brief report: psychosocial factors and pediatric noncardiac chest pain. J Pediatr Psychol. 2009;34:1170–4.
Kislal FM, Kutluk T, Cetin FC, et al. Psychiatric symptoms of adolescents with physical complaints admitted to an adolescence unit. Clin Pediatr. 2005;44:121–30.
Lipsitz JD, Masia C, Apfel H, et al. Noncardiac chest pain and psychopathology in children and adolescents. J Psychosom Res. 2005;59:185–8.
Lipsitz JD, Masia-Warner C, Apfel H, et al. Anxiety and depressive symptoms and anxiety sensitivity in youngsters with noncardiac chest pain and benign heart murmurs. J Pediatr Psychol. 2004;29:607–12.
Muris P, Hoeve I, Meesters C, et al. Children’s perception and interpretation of anxiety-related physical symptoms. J Behav Ther Exp Psychiatry. 2004;35:233–44.
White KS. Assessment and treatment of psychological causes of chest pain. Med Clin North Am. 2010;94:291–318.
Masia-Warner C, Reigada LC, Fisher PH, et al. CBT for anxiety and associated somatic complaints in pediatric medical settings: an open pilot study. J Clin Psychol Med Settings. 2009;16:169–77.
Alpert MA, Mukerji V, Sabeti M, Russell JL, Beitman BD. Mitral valve prolapsed, panic disorder, and chest pain. Med Clin North Am. 1991;75:1119–33.
Boudoulas H, King BD, Wooley CF. Mitral valve prolapsed: a marker for anxiety or overlapping phenomenon? Psychopathology. 1984;17 suppl 1:98–106.
Boudoulas H, Reynolds JC, Mazzaferri E, Wooley CF. Metabolic studies in mitral valve prolapse syndrome. A neuroendocrine-cardiovascular process. Circulation. 1980;61(6):1200–5.
Lembo AJ. Visceral hypersensitivity in noncardiac chest pain. Gastroenterol Clin North Am. 2004;33(1):55–60.
Chahal PS, Rao SS. Functional chest pain: nociception and visceral hyperalgesia. J Clin Gastroenterol. 2005;39 suppl 3:S204–9.
Lee H, Kim JH, Min BH, et al. Efficacy of venlafaxine for symptomatic relief in young adult patients with functional chest pain: a randomized, double-blind, placebo-controlled, crossover trial. Am J Gastroenterol. 2010;105(7):1504–12.
Bradley LA, Richter JE, Scarinci IC, Haile JM, Schan CA. Psychological and psychophysical assessments of patients with unexplained chest pain. Am J Med. 1992;92(suppl 5A):65S–73S.
National Institutes of Mental Health. Anxiety Disorders. NIH Publication 09 3879. Washington: US Department of Health and Human Services; 2009. http://www.nimh.nih.gov/health/publications/anxiety-disorders/nimhanxiety.pdf
Homnick DN. Respiratory system. In: Greydanus DE, Feinberg A, Patel DR, Homnick DN, Reddy V, editors. The pediatric diagnostic examination. New York: McGraw Hill; 2008.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Patel, D.R. (2012). Chest Pain. In: Anbar, R.D. (eds) Functional Respiratory Disorders. Respiratory Medicine. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-61779-857-3_3
Download citation
DOI: https://doi.org/10.1007/978-1-61779-857-3_3
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-61779-856-6
Online ISBN: 978-1-61779-857-3
eBook Packages: MedicineMedicine (R0)