Effectiveness of Screening for Life-Threatening Chest Pain in Children
Saleeb SF et al. – Chest pain (CP) in children is a common complaint and rarely has a cardiac cause. Review of 1 decade of cardiology visits (nearly 18 000 patient years) revealed that no patient discharged from the clinic died as a result of a cardiac condition.Methods
- The records of children >6 years of age who presented to Children's Hospital Boston between January 1, 2000, and December 31, 2009, with a complaint of CP were reviewed for demographic features, clinical characteristics, resource utilization, and presumed diagnosis.
- Patients were searched for in the US National Death Index and Social Security Death Index.
- Data for a total of 3700 patients with CP (median age at evaluation: 13.4 years [range: 7–22.3 years]) were reviewed.
- The median follow–up period was 4.4 years (range: 0.5–10.4 years), for total of 17 886 patient–years of follow–up data.
- CP with exertion occurred in 1222 cases (33%), including 15 with associated syncope.
- A cardiac cause was determined in 37 cases; the remaining 3663 patients (99%) had CP of unknown (n = 1928), musculoskeletal (n = 1345), pulmonary (n = 242), gastrointestinal (n = 108), anxiety–related (n = 34), or drug–related (n = 4) origin.
- Emergency department visits for CP were documented for 670 patients (18%), and 263 patients (7%) had cardiology follow–up visits related to CP.