I just came across this fantastic video from the Cincinnati Children’s Hospital Medical Center Blog and Cardiologist Nicolas Madsen. Chest pain is a very common presenting symptom in the Pediatric Emergency Department, and families are often very worried about the heart. To quote many a Cardiologist – with some paraphrasing, “It’s not (usually) the heart.”
The video is only five minutes long, and well worth a view. After watching it I suspect you will be able to take several new things back to the bedside to help make your history taking more robust, and enhance your ability to reassure the family, who is often worried about the worst case scenario.
And remember, red flags for chest pain in otherwise health kids include:
- Chest pain with activity
- Chest pain with syncope
In general, short brief episodes that are reproduced by pressing on the chest wall (i.e. reproducible chest pain) are generally reassuring.
You can follow Dr. Madsen on Twitter @MadsenNicolas