Noncardiac Chest Pain (Child)

Chest pain in children can have many causes. Most are not serious. A child’s chest pain can be very frightening to a parent. But know that your child’s pain is not related to his or her heart.

Chest pain not related to the heart has many causes. These may include:

  • Stress or anxiety may be from separation or family issues such as the death of a relative

  • Stomach acid coming up into the food tube (esophagus). This might be reflux, GERD, or heartburn.

  • Irritation of the esophagus

  • Swallowing an object or a substance

  • Lots of coughing that causes inflammation. This might be because of a respiratory infection such as a cold or the flu, bronchitis, or asthma.

  • Pinched nerve

  • Breast enlargement. This can occur in both girls and boys.

  • Chest wall muscle pain or strain

  • Inflammation or infection of the lining or tissue of the lung (pleurisy)

  • Rib pain or inflammation

Home care

Your child’s healthcare provider may prescribe medicines for pain or related symptoms such as a cough. Follow the provider’s instructions for giving these medicines to your child. Don’t give your child any medicines that the provider has not approved.

General care

  • Let your child do his or her normal activities, as advised by your child’s healthcare provider and as tolerated.

  • Learn to recognize your child’s signs of pain. Try to find comfort measures that soothe your child.

  • Position your child so that he or she is as comfortable as possible when having chest pain. Change his or her position as needed.

  • Put a covered heating pad (on warm setting, not hot) or warm cloth on the affected area. Do this for 20 minutes, 4 times a day.

  • Ask your child’s provider about exercises to stretch the chest muscles. These may help ease pain.

  • Talk with your child’s provider about the causes of your child’s pain. The provider may suggest other ways to ease it.

  • Anti-inflammatory or steroid medicines may help reduce the pain. Talkwith your child's healthcare provider to find out if this is needed.

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

When to seek medical advice

Call your child’s healthcare provider right away if any of these occur:

  • Fever (see Fever and children, below)

  • Symptoms don’t get better even with medicine or other treatment

  • Behavior changes

  • Chest pains come back again and again

  • Symptoms don't get better within 7 days

Call 911

This is the fastest and safest way to get to the emergency department. The paramedics can also start treatment on the way the hospital, if needed.

Call 911, or seek medical attention right away, if any of the following occur:

  • Trouble breathing, shortness of breath, or fast breathing

  • Your child acts very ill or is too weak to stand

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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