Çocuklarda Göğüs Ağrısı Yönetimi
Synopsis
Chest pain in children and adolescents is a common reason for visits to hospitals and pediatric cardiology clinics; however, unlike in the adult population, cardiac etiology accounts for only a small fraction of 1-10% of cases. The most common causes of chest pain in childhood are non-cardiac pathologies, stemming from musculoskeletal conditions, respiratory system infections, gastrointestinal disorders, psychogenic factors, or most frequently, idiopathic conditions. The main principle in managing children presenting with chest pain is to determine that the pain is not of cardiac origin, avoid unnecessary diagnostic tests, and reassure the patient and their family. In this process, a comprehensive medical and family history must be taken, and a detailed physical examination including vital signs and cardiovascular system evaluation should be performed. Anginal pain, exercise-induced pain, accompanying syncope or palpitations, a history of heart disease, or a family history of sudden death under the age of 50 are red flags suggesting a cardiac origin. In children with normal medical history, physical examination, and ECG findings, serious cardiac pathologies are largely ruled out. However, in the presence of red flags or abnormal findings, patients must be referred to a pediatric cardiologist for echocardiography and further evaluation.
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