Needles in hay: chest pain as the presenting symptom in children with serious underlying cardiac pathology

Congenital Heart Disease
David A KaneRobert L Geggel


Chest pain in children is common, but rarely heralds serious underlying cardiac pathology. Despite this, the anxiety of missing a potentially life threatening condition creates a large burden of referrals and diagnostic testing. We evaluated patients diagnosed with 1 of 9 serious cardiac diseases and detailed the clinical signs and symptoms of the patients presenting with chest pain. Patients diagnosed between the ages of 7 and 21 years from January 2000 to December 2009 at Children's Hospital Boston (CHB) were identified from a database using diagnostic and billing codes for aortic dissection, coronary anomalies, dilated cardiomyopathy, hypertrophic cardiomyopathy, myocarditis, pericarditis, pulmonary embolus, pulmonary hypertension, and Takayasu arteritis. Patients with previously diagnosed congenital or acquired heart disease were excluded. Four hundred eighty-four patients were included and 35% presented with chest pain. Forty-one (24%) of these patients with chest pain were diagnosed in the outpatient cardiology clinic, while the remaining 130 patients (76%) were diagnosed in the emergency department (ED) or inpatient setting. Coronary artery anomalies were the most common diagnosis made in cardiology clinic, and 16 of the...Continue Reading


Nov 14, 1997·Journal of the American College of Cardiology·B LauerH P Schultheiss
May 22, 2002·Circulation·Paolo AngeliniScott Flamm
Apr 25, 2003·The New England Journal of Medicine·Steven E LipshultzSteven D Colan
Aug 6, 2004·Pediatric Emergency Care·Andrew S Johnson, Robert G Bolte
Dec 8, 2004·Annals of Internal Medicine·Robert E EckartRenu Virmani
Mar 29, 2005·Pediatric Cardiology·J SoongswangN Limpimwong
Dec 19, 2006·Cardiology in Review·Vignendra Ariyarajah, David H Spodick
Sep 18, 2007·Chest·Nina M PatelSteven M Kawut
Dec 7, 2007·Pediatrics·Stephen B FreedmanJennifer Thull-Freedman
Nov 14, 2008·Pediatric Radiology·Teresa VictoriaSandra S Kramer
Apr 10, 2009·The New England Journal of Medicine·Leslie T Cooper
Jun 26, 2009·Vascular Health and Risk Management·Amy Hawkins, Robert Tulloh
Jul 25, 2009·The New England Journal of Medicine·John R Kapoor

❮ Previous
Next ❯


May 8, 2013·Cardiology in the Young·Matthew C SchwartzShobha Natarajan
Sep 6, 2011·Radiologic Clinics of North America·Frederick D Grant, S Ted Treves
Jul 27, 2010·Congenital Heart Disease·Rahul H RathodJames E Lock
Aug 14, 2012·Congenital Heart Disease·W Buck KyleBryan C Cannon
Jun 19, 2013·The Journal of Pediatrics·Kevin G Friedman, Mark E Alexander
Dec 5, 2013·Archives of Disease in Childhood. Education and Practice Edition·Samuel A CollinsJulian P Legg
Mar 30, 2017·JAAPA : Official Journal of the American Academy of Physician Assistants·Marie L ShanerDennis Chang
Feb 28, 2017·The Journal of Pediatrics·Kirsten Rose-FelkerRitu Sachdeva
Apr 4, 2017·The Journal of Pediatrics·Tuan NguyenLeo Lopez
Oct 9, 2014·Academic Medicine : Journal of the Association of American Medical Colleges·Michael FariasRahul H Rathod
Feb 6, 2017·Journal of the American College of Cardiology·Devyani ChowdhuryUNKNOWN American College of Cardiology’s Adult Congenital and Pediatric Cardiology Section’s Ambulatory Pediatric Cardiology Quality
Jun 28, 2017·Congenital Heart Disease·Jimmy C LuRoy Jedeikin
Apr 13, 2012·Clinical Pediatrics·Shafkat Anwar, Rae-Ellen W Kavey
Mar 15, 2018·Pediatric Annals·Gul H DadlaniNicholas Erbrich
Feb 21, 2016·Journal of the American Heart Association·Yvonne ParisUNKNOWN New England Congenital Cardiology Association (NECCA)
Jul 24, 2013·Circulation·Gerald F FletcherUNKNOWN American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee of the Council on Clinical Cardiology,
Jul 1, 2011·Expert Review of Cardiovascular Therapy·Kathleen E Simpson, Charles E Canter
Sep 6, 2019·Pediatric Cardiology·Tamer Yoldaş, Utku Arman Örün
May 31, 2011·Current Sports Medicine Reports·Sarina K BeheraAnthony Luke
Sep 26, 2017·Congenital Heart Disease·Susan F SaleebDavid R Fulton
Aug 23, 2019·Congenital Heart Disease·Soham DasguptaMatthew E Oster
Nov 2, 2012·Pediatric Emergency Care·Matthew A EisenbergVincent W Chiang
Jun 11, 2021·The Journal of Emergency Medicine·Michael GottliebBrit Long

❮ Previous
Next ❯

Related Concepts

Related Feeds


Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.

Aortic Coarctation

Aortic coarctation is a congenital condition characterized by narrowing of the aorta. Discover the latest research on this disease here.