Chest Pain  

This Care Guide Covers:

  • Pain or discomfort in the chest (front or back)
  • The chest includes from the top to the bottom of the rib cage

If not, see these topics
When to Call Your Doctor

Call 911 Now (your child may need an ambulance) If
  • Severe trouble breathing (struggling for each breath, can barely speak or cry)
  • Passed out (fainted)
  • Bluish lips or face
  • Not moving or too weak to stand
  • You think your child is having a life-threatening emergency
Call Your Doctor Now (night or day) If
  • Your child looks or acts very sick
  • Your child has heart disease
  • Trouble breathing, but not severe
  • Taking a deep breath makes the pain worse
  • Severe chest pain
  • Heart is beating very rapidly
  • After a direct blow to the chest
  • You think your child needs to be seen urgently
Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • You think your child needs to be seen, but not urgently
  • Fever is present
  • Cause of chest pain is not clear. (Exception: Pain due to coughing, sore muscles, heartburn or other clear cause)
Call Your Doctor During Weekday Office Hours If
  • You have other questions or concerns
  • Chest pains only occur with hard exercise (such as running)
  • Sore muscles last over 7 days
  • Heartburn lasts over 2 days on treatment
  • Chest pains are a frequent problem
Parent Care at Home If
  • Normal chest pain from sore muscles
  • Normal chest pain from heartburn
Causes & Health Information

Causes

  • Muscle Overuse. Chest pain can follow hard sports (such as throwing a baseball). Lifting (such as weights) or upper body work (such as digging) can also cause it. This type of muscle soreness often increases with movement of the shoulders.
  • Muscle Cramps. Most brief chest pain lasting minutes is from harmless muscle cramps. It can also be caused by a pinched nerve.
  • Coughing. Chest pain commonly occurs with a hacking cough. Coughing can cause sore muscles in the chest wall, upper abdomen or diaphragm. Asthma can cause chest pain this way.
  • Heartburn. Heartburn is due to reflux of stomach contents.  It usually causes a burning pain under the lower sternum (breastbone).
  • Heart disease is hardly ever the cause of chest pain in children.

Pain Scale

  • Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
  • Moderate: The pain keeps your child from doing some normal activities.  It may wake him or her up from sleep.
  • Severe: The pain is very bad. It keeps your child from doing all normal activities.         
CARE ADVICE FOR CHEST PAIN

Treatment for Sore Muscle Pain
  1. What You Should Know:
    • Chest pains in children lasting for a few minutes are usually harmless. The pain can be caused by muscle cramps. They need no treatment.
    • Chest pains can be from hard work or sports that use the upper body. Sore muscles can start soon after the event.
    • Here is some care advice that should help.
  2. Pain Medicine:
    • To help with the pain, give acetaminophen (such as Tylenol) or ibuprofen. Use as needed. See Dose Table.
    • Continue this until 24 hours have passed without pain.
  3. Cold Pack:
    • For the first 2 days, use a cold pack to help with the pain.
    • You can also use ice wrapped in a wet cloth.
    • Put it on the sore muscles for 20 minutes, then as needed.
    • Caution: Avoid frostbite. 
  4. Heat Pack:
    • If pain lasts over 2 days, put heat on the sore muscle.
    • Use a heat pack, heating pad or warm wet washcloth.
    • Do this for 10 minutes, then as needed.
    • Caution: Avoid burns.
    • A hot shower may also help.
  5. Stretching the Muscles:
    • Gentle stretching of the shoulders and chest wall may help.
    • Do sets of 10 twice daily.
    • This may prevent muscle cramps from coming back.
    • Stretching can be continued even during the chest pain. Do not do any that increase the pain.
  6. What to Expect:
    • For sore muscles, the pain most often peaks on day 2.
    • It can last up to 6 or 7 days.
  7. Call Your Doctor If:
    • Pain becomes severe
    • Pain lasts over 7 days on treatment
    • Your child becomes worse
Treatment for Heartburn (Reflux) Pain
  1. What You Should Know:
    • Heartburn is common.
    • It's due to stomach acid going up into the esophagus. The esophagus is the tube from the mouth to the stomach.
    • Heartburn causes a burning pain behind the lower part of the breastbone. It also causes a sour (acid) taste in the mouth and belching.
    • Here is some care advice that should help.
  2. Antacids:
    • Heartburn is usually easily treated. Give 1 to 2 tablespoons (15 - 30 ml) of liquid antacid by mouth. You can use Mylanta or the store brand. No prescription is needed.
    • If you don't have an antacid, use 2 to 3 ounces (60 - 90 ml) of milk.
    • For heartburn that keeps coming back, give an antacid 1 hour before meals. Also, give a dose at bedtime. Do this for a few days.
  3. Heartburn Prevention:
    • Do not eat too much at meals. This overfills the stomach.
    • Do not eat foods that make heartburn worse. Examples are chocolate, fatty foods, spicy foods, carbonated soda, and caffeine.
    • Do not bend over during the 3 hours after meals.
    • Do not wear tight clothing or belts around the waist.
  4. What to Expect:
    • Most often, heartburn goes away with treatment.
    • But, heartburn also tends to come back. So, preventive measures are important. 
  5. Call Your Doctor If:
    • Heartburn doesn't go away 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.
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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 9/1/2012

Last Revised: 1/13/2013

Content Set: Child Symptom Checker

Copyright 1994-2012 Barton D. Schmitt, M.D.