Chest Pain

DEFINITION

• Pain or discomfort in the chest (front or back)
• This includes the area from the lower neck to the bottom of the rib cage

• Most persistent chest pain is from a hacking cough. Coughing can cause sore muscles in the chest wall, upper abdomen or diaphragm.
• Occasionally, chest pain follows strenuous exercise (e.g., throwing a baseball), lifting (e.g., weights or heavy boxes), or work that involves the upper body (e.g., digging). This type of muscle soreness often increases with movement of the shoulders.
• Most brief chest pain lasting minutes is from harmless muscle cramps or a pinched nerve.
• Heart disease is hardly ever the cause of chest pain in children.

See More Appropriate Topic (instead of this one) If

• Has asthma symptoms, see ASTHMA ATTACK
• Caused by a cough, see COUGH

WHEN TO CALL YOUR DOCTOR

HOME CARE ADVICE FOR CHEST PAIN

Treatment for Sore Muscle Pain

1. Reassurance:
   • Chest pains in children lasting for a few minutes are usually harmless muscle cramps. They need no treatment.
   • Chest pains (sore muscles) from vigorous exercise or work using the upper body usually start soon after the activity and need the following treatment.
2. Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen. Continue this until 24 hours have passed without pain.
3. Local Heat: Apply local heat for 20 minutes 4 times a day. Use a heating pad, warm washcloth or hot shower to the area.
4. Stretching Exercises: Gentle stretching exercises of the shoulders and chest wall in sets of 10 twice daily may prevent recurrence of muscle cramps. Stretching exercises can be continued even during active chest pain. Avoid any that increase the pain.
5. Expected Course: For sore muscles, the pain usually peaks on day 2 and lasts 6 or 7 days.
6. Call Your Doctor If:
   • Pain becomes severe
   • Pain lasts over 7 days on treatment
   • Your child becomes worse

Treatment for Heartburn (Reflux) Pain

1. Reassurance:
   • Heartburn is common
   • It's due to stomach acid refluxed up into the esophagus
   • Causes a burning discomfort behind the lower sternum, a sour (acid) taste in the mouth and belching
2. Antacids:
   • Heartburn is usually easily relieved by 1 to 2 tablespoons (15 - 30 ml) of liquid antacid by mouth.
   • If you don't have an antacid, wash out the esophagus with 2 to 3 ounces (60 - 90 ml) of milk.
     
   • For persistent heartburn, give antacid 1 hour before meals and at bedtime for a few days.
     
3. Heartburn Prevention:
   • Avoid overeating which overfills the stomach
   • Avoid foods that increase reflux (chocolate, fatty foods, spicy foods, carbonated soda, caffeine)
   • Avoid bending over during the 3 hours after meals
   • Avoid tight clothing or belts around the waist
4. Call Your Doctor If:
   • Heartburn doesn't resolve after 2 days of treatment
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.