Çocuk ve Adölesanlarda Göğüs Ağrısı
Özet
Çocuklarda göğüs ağrısı genellikle kas-iskelet sistemi, solunum veya psikojenik kaynaklı olup ciddi bir kardiyak neden görülme oranı oldukça düşüktür. Tanı aşamasında detaylı bir öykü ve fizik muayene genellikle yeterli olurken, ağrının egzersizle ilişkili olması veya bayılma gibi belirtilerin eşlik etmesi durumunda ileri kardiyolojik değerlendirme gerekmektedir.
Chest pain in children and adolescents is most commonly caused by non-cardiac issues, such as musculoskeletal conditions, while serious cardiac pathologies are identified in only 0% to 5% of cases. A thorough patient history and physical examination are typically sufficient to diagnose the underlying cause and provide necessary reassurance to concerned families.
Referanslar
Cava JR, Sayger PL. Chest pain in children and adolescents. Pediatr Clin North Am 2004; 51(6): 1553-68, viii. 2004/11/25. doi: 10.1016/j.pcl.2004.07.002.
Gesuete V, Fregolent D, Contorno S, Tamaro G, Barbi E, Cozzi G. Follow-up study of patients admitted to the pediatric emergency department for chest pain. Eur J Pediatr 2020; 179(2): 303-8. 2019/11/16. doi: 10.1007/s00431-019-03495-5.
Selbst SM, Ruddy RM, Clark BJ, Henretig FM, Santulli T, Jr. Pediatric chest pain: a prospective study. Pediatrics 1988; 82(3): 319-23. 1988/09/01.
Lipsitz JD, Masia-Warner C, Apfel H, Marans Z, Hellstern B, Forand N, et al. Anxiety and depressive symptoms and anxiety sensitivity in youngsters with noncardiac chest pain and benign heart murmurs. J Pediatr Psychol 2004; 29(8): 607-12. 2004/10/20. doi: 10.1093/jpepsy/jsh062.
Blake JM. A teen with chest pain. Pediatr Clin North Am 2014; 61(1): 17-28. 2013/11/26. doi: 10.1016/j.pcl.2013.09.008.
Lipsitz JD, Masia C, Apfel H, Marans Z, Gur M, Dent H, et al. Noncardiac chest pain and psychopathology in children and adolescents. J Psychosom Res 2005; 59(3): 185-8. 2005/10/04. doi: 10.1016/j.jpsychores.2005.05.004.
Lee JL, Gilleland J, Campbell RM, Simpson P, Johnson GL, Dooley KJ, et al. Health care utilization and psychosocial factors in pediatric noncardiac chest pain. Health Psychol 2013; 32(3): 320-7. 2012/04/11. doi: 10.1037/a0027806.
Loiselle KA, Lee JL, Gilleland J, Campbell R, Simpson P, Johnson G, et al. Factors associated with healthcare utilization among children with noncardiac chest pain and innocent heart murmurs. J Pediatr Psychol 2012; 37(7): 817-25. 2012/04/12. doi: 10.1093/jpepsy/jss055.
Friedman KG, Alexander ME. Chest pain and syncope in children: a practical approach to the diagnosis of cardiac disease. J Pediatr 2013; 163(3): 896-901 e1-3. 2013/06/19. doi: 10.1016/j.jpeds.2013.05.001.
Kocis KC. Chest pain in pediatrics. Pediatr Clin North Am 1999; 46(2): 189-203. 1999/04/28. doi: 10.1016/s0031-3955(05)70112-7.
Saleeb SF, Li WY, Warren SZ, Lock JE. Effectiveness of screening for life-threatening chest pain in children. Pediatrics 2011; 128(5): e1062-8. 2011/10/12. doi: 10.1542/peds.2011-0408.
Brown RT. Costochondritis in adolescents. J Adolesc Health Care 1981; 1(3): 198-201. 1981/03/01. doi: 10.1016/s0197-0070(81)80056-3.
Porter GE. Slipping rib syndrome: an infrequently recognized entity in children: a report of three cases and review of the literature. Pediatrics 1985; 76(5): 810-3. 1985/11/01.
Pickering D. Precordial catch syndrome. Arch Dis Child 1981; 56(5): 401-3. 1981/05/01. doi: 10.1136/adc.56.5.401.
Di Nisio M, van Es N, Buller HR. Deep vein thrombosis and pulmonary embolism. Lancet 2016; 388(10063): 3060-73. 2016/07/05. doi: 10.1016/S0140-6736(16)30514-1.
Friedman KG, Kane DA, Rathod RH, Renaud A, Farias M, Geggel R, et al. Management of pediatric chest pain using a standardized assessment and management plan. Pediatrics 2011; 128(2): 239-45. 2011/07/13. doi: 10.1542/peds.2011-0141.
Woolf PK, Gewitz MH, Berezin S, Medow MS, Stewart JM, Fish BG, et al. Noncardiac chest pain in adolescents and children with mitral valve prolapse. J Adolesc Health 1991; 12(3): 247-50. 1991/05/01. doi: 10.1016/0197-0070(91)90018-h.
Berezin S, Medow MS, Glassman MS, Newman LJ. Chest pain of gastrointestinal origin. Arch Dis Child 1988; 63(12): 1457-60. 1988/12/01. doi: 10.1136/adc.63.12.1457.
Asnes RS, Santulli R, Bemporad JR. Psychogenic chest pain in children. Clin Pediatr (Phila) 1981; 20(12): 788-91. 1981/12/01. doi: 10.1177/000992288102001206.
Pillay AL, Lalloo M. Psychogenic pain disorder in children. S Afr Med J 1989; 76(5): 195-6. 1989/09/02.
Neill WA, Hattenhauer M. Impairment of myocardial O2 supply due to hyperventilation. Circulation 1975; 52(5): 854-8. 1975/11/01. doi: 10.1161/01.cir.52.5.854.
Tunaoglu FS, Olgunturk R, Akcabay S, Oguz D, Gucuyener K, Demirsoy S. Chest pain in children referred to a cardiology clinic. Pediatr Cardiol 1995; 16(2): 69-72. 1995/03/01. doi: 10.1007/BF00796820.
Rowland TW, Richards MM. The natural history of idiopathic chest pain in children. A follow-up study. Clin Pediatr (Phila) 1986; 25(12): 612-4. 1986/12/01. doi: 10.1177/000992288602501205.
Vichinsky EP, Styles LA, Colangelo LH, Wright EC, Castro O, Nickerson B. Acute chest syndrome in sickle cell disease: clinical presentation and course. Cooperative Study of Sickle Cell Disease. Blood 1997; 89(5): 1787-92. 1997/03/01.
Carabello BA, Paulus WJ. Aortic stenosis. Lancet 2009; 373(9667): 956-66. 2009/02/24. doi: 10.1016/S0140-6736(09)60211-7.
Arfken CL, Lachman AS, McLaren MJ, Schulman P, Leach CN, Jr., Farrish GC. Mitral valve prolapse: associations with symptoms and anxiety. Pediatrics 1990; 85(3): 311-5. 1990/03/01.
Newburger JW, Takahashi M, Gerber MA, Gewitz MH, Tani LY, Burns JC, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Pediatrics 2004; 114(6): 1708-33. 2004/12/03. doi: 10.1542/peds.2004-2182.
Frommelt PC, Frommelt MA. Congenital coronary artery anomalies. Pediatr Clin North Am 2004; 51(5): 1273-88. 2004/08/28. doi: 10.1016/j.pcl.2004.04.014.
Molossi S, Sachdeva S. Anomalous coronary arteries: what is known and what still remains to be learned? Curr Opin Cardiol 2020; 35(1): 42-51. 2019/10/22. doi: 10.1097/HCO.0000000000000696.
Fikar CR, Fikar R. Aortic dissection in childhood and adolescence: an analysis of occurrences over a 10-year interval in New York State. Clin Cardiol 2009; 32(6): E23-6. 2009/03/27. doi: 10.1002/clc.20383.
Kane DA, Fulton DR, Saleeb S, Zhou J, Lock JE, Geggel RL. Needles in hay: chest pain as the presenting symptom in children with serious underlying cardiac pathology. Congenit Heart Dis 2010; 5(4): 366-73. 2010/07/27. doi: 10.1111/j.1747-0803.2010.00436.x.
Lange RA, Hillis LD. Clinical practice. Acute pericarditis. N Engl J Med 2004; 351(21): 2195-202. 2004/11/19. doi: 10.1056/NEJMcp041997.
Westover AN, Nakonezny PA, Haley RW. Acute myocardial infarction in young adults who abuse amphetamines. Drug Alcohol Depend 2008; 96(1-2): 49-56. 2008/03/21. doi: 10.1016/j.drugalcdep.2008.01.027.
Qureshi AI, Suri MF, Guterman LR, Hopkins LN. Cocaine use and the likelihood of nonfatal myocardial infarction and stroke: data from the Third National Health and Nutrition Examination Survey. Circulation 2001; 103(4): 502-6. 2001/02/07. doi: 10.1161/01.cir.103.4.502.
Collins SA, Griksaitis MJ, Legg JP. 15-minute consultation: a structured approach to the assessment of chest pain in a child. Arch Dis Child Educ Pract Ed 2014; 99(4): 122-6. 2013/12/05. doi: 10.1136/archdischild-2013-303919.
Selbst SM. Approach to the child with chest pain. Pediatr Clin North Am 2010; 57(6): 1221-34. 2010/11/30. doi: 10.1016/j.pcl.2010.09.003.
Selbst SM. Chest pain in children. Pediatrics 1985; 75(6): 1068-70. 1985/06/01.
Harris TH, Gossett JG. Diagnosis and Diagnostic Modalities in Pediatric Patients with Elevated Troponin. Pediatr Cardiol 2016; 37(8): 1469-74. 2016/08/31. doi: 10.1007/s00246-016-1459-7.
