Pediatric chest pain is a relatively common presenting complaint, but identifying serious pathologies without overtesting patients with less-serious pathologies can be a challenge for emergency clinicians.
Our recent Pediatric Chest Pain: Using Evidence to Reduce Diagnostic Testing in the Emergency Department issue reviews the available literature to provide evidence-based recommendations to support a more standardized approach to the evaluation and management of pediatric patients with chest pain.
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Here are a few key points:
- One of the largest ED studies of pediatric chest pain patients found the most common etiologies for non–cardiac chest pain included: musculoskeletal disorders/unspecified chest pain (56%), respiratory (12%), infectious (8%), gastrointestinal (6%), and sickle cell-related causes (4%). In this study, only 0.6% of the patients had cardiac-related chest pain.
- A cardiac cause should be considered in patients with red-flag findings. (See Table 1 in the issue.)