Chest Pain with Uncertain Cause (Child)

Chest pain in children can have many causes. Most are not serious. Sometimes chest pain is caused by stress or anxiety. Your child may have chest pain from heartburn (stomach acid reflux), a muscle strain, or lots of coughing. Or the pain may be from inflammation of the cartilage and joints connecting the ribs to the breastbone (sternum). A child may have a hard time describing the pain, so it can be hard for you to figure out the cause. In some cases, the cause of chest pain is not known. In most children and teens, chest pain isn't caused by a serious medical condition.

Home care

The healthcare provider may prescribe medicines for pain or other symptoms, such as a cough. Follow all instructions for giving these medicines to your child. Don’t give your child any medicines that the provider hasn't approved.

General care

  • Allow your child to do normal activities, as advised by your healthcare provider and as tolerated by your child. If an activity makes the pain worse, have your child rest.

  • Position your child so that they are as comfortable as possible when having chest pain. Change their position as needed.

  • A cold pack may help if the healthcare provider thinks the pain is from a sore muscle. For the first 2 days, use a cold pack on the sore muscle for 20 minutes, then as needed. Most young children won't use a cold pack because they don't like the feel of the cold. Don't force your child to use one.

  • If your child still has sore muscle pain after 2 days, apply a covered heating pad set on warm—not hot—or a warm cloth to the chest for 10 minutes, then as needed. If the pain seems worse after several hours, stop using heat.

  • Ask the healthcare provider about stretches for the chest muscles that may help ease pain.

  • If the provider thinks the pain is from heartburn, watch what your child eats. Limit junk food. Don't give your child a meal just before bedtime, and avoid large meals.

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

  • Acetaminophen or ibuprofen can be used to treat sore or strained chest muscles. Don't give your child aspirin unless told to do so by the healthcare provider.

Follow-up care

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

Call 911

Call 911 if your child:

  • Has severe shortness of breath or is turning blue (cyanosis)

  • Faints or loses consciousness

  • Is too weak to stand or move

  • Has an abnormal heartbeat

When to get medical advice

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

  • Existing heart disease

  • Fever

  • Symptoms don’t go away with medicine or other treatment

  • Symptoms worsen

  • Trouble breathing

  • Fast breathing

  • Rapid heartbeat

  • Your child looks or acts very ill

  • The pain is severe and lasts for a prolonged period

  • Chest pain improves, but then worsens again

  • Child has a direct blow to the chest

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