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Chest Pain — Differential Diagnosis — Clinical Pathway: Emergency

Chest Pain Clinical Pathway — Emergency Department

Differential Diagnosis of Chest Pain in Children

The following list is not exhaustive but provides an overview of examples of pediatric chest pain.

Cardiac-related Causes
  • Coronary Artery Anomalies
    • Anomalous coronary artery
    • Kawasaki disease
  • Tachyarrhythmias
    • SVT
    • VT
  • Structural and Myocardial Abnormalities
    • Cardiomyopathy
    • Aortic valve stenosis
  • Inflammatory Conditions
    • Myocarditis
    • Pericarditis
    • Myopericarditis
    • Postpericardiotomy syndrome
  • Aortic Dissection
Other Causes
  • Musculoskeletal Disorders
    • Chest wall strain
    • Direct trauma, contusion, rib fracture
    • Costochondritis
    • Tietze syndrome
    • Texidor's Twinge/precordial catch
  • Respiratory Disorders
    • Pulmonary embolism
    • Severe cough
    • Asthma
    • Pneumonia
    • Pneumothorax, pneumomediastinum
    • Pleurisy
  • Psychological Disorders
    • Anxiety
  • GI Disorders
    • Reflux esophagitis
    • Esophageal foreign body, caustic ingestion
    • Pill induced esophagitis
    • Esophageal spasm
    • Referred abdominal pain
  • Miscellaneous
    • Sickle cell disease with vaso-occlusive crisis
    • Herpes zoster
    • Breast tenderness (physiologic, pregnancy)
    • Chest mass
    • Idiopathic

Reference

Approach to the Child with Chest Pain  

 

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