Use this pathway to guide the evaluation of the chief complaint of chest pain in healthy patients without known cardiac disease.
Chest pain is a common chief complaint in pediatric outpatient and emergency department visits (0.6-5%) and is the 2nd most common reason for referral to a pediatric cardiologist. Parents and patients are concerned about the possibility of heart disease which could be very serious and/or life-threatening. However, cardiac etiologies are exceedingly rare in healthy children and adolescents, < 1% of those seen in the general outpatient setting or emergency department. In fact, of those referred to a Pediatric Cardiologist, a cardiac etiology will be found on only 2% of patients.
A thorough history and physical examination will elucidate the etiology or generate a short, specific differential diagnosis. Thus routine laboratory and radiographic testing are not routinely indicated.