Parent’s Guide

Parent’s Guide: Chest Pain in Children

First, take a deep breath. When adults feel chest pain, we immediately worry about heart attacks. In children, heart disease is almost never the cause.
Most chest pain in kids is caused by muscles, ribs, acid reflux, or anxiety. This guide will help you figure out what is happening and when to call the doctor.

1

🚨 When to Get Help

Call 911 Now

  • Severe Breathing Trouble: Struggling for each breath, can barely speak or cry.
  • Consciousness: Child has passed out (fainted) or is hard to wake.
  • Color: Lips or face turn blue.
  • Trauma: The pain started after a severe hit to the chest (car accident, hard tackle).

Call Doctor Now or Go to ER

  • Deep Breaths: The pain gets much worse when taking a deep breath (could be Pleurisy/Pneumonia).
  • Heart Rate: The heart is beating very fast or pounding (palpitations) while resting.
  • History: Your child has known heart disease or a previous heart surgery.
  • Trauma: A direct blow to the chest (like a baseball or playground fall) occurred recently.
  • Appearance: Your child looks or acts very sick.

Contact in 24hrs

  • Exercise-Induced: The pain only happens during hard exercise (like running) and goes away with rest.
  • Duration: Sore muscles have lasted more than 1 week.
  • Fever: A fever is present along with the pain.
  • Frequency: The chest pain happens often/recurrently.
2

🔍 What Caused This? (Common Triggers)

If it is not an emergency, the cause is likely one of these common, harmless issues:

1. Musculoskeletal Pain (Most Common)

  • Muscle Overuse: Soreness from lifting weights, digging, or throwing a ball. The chest muscles are just like leg muscles—they get sore after a workout.
  • “Precordial Catch” (Muscle Cramp): A sharp, stabbing pain that happens suddenly, lasts a few seconds or minutes, and vanishes. It often hurts to take a deep breath during the “catch.” This is harmless and caused by a pinched nerve or cramp between the ribs.
  • Coughing: A hard virus or hacking cough can strain the muscles between the ribs, making the chest feel bruised.

2. Stomach Issues

  • Heartburn (Reflux): A burning pain behind the breastbone or lower ribs. Often happens after eating spicy food, chocolate, or overeating. May come with a sour taste in the mouth.

3. Lungs

  • Asthma: If your child has asthma, a “tight chest” is a common symptom of a flare-up.

4. Stimulants

  • Caffeine: Too much soda, coffee, or Energy Drinks can cause a racing heart, which kids interpret as chest pain. ADHD medication can sometimes cause this too.
3

🏠 Home Care Advice

If it is Muscle Pain (Strain or Overuse)

1. Pain Medicine

  • Give Ibuprofen (Advil/Motrin) or Acetaminophen (Tylenol) to help with the soreness.

2. The Ice vs. Heat Rule

  • First 48 Hours: Use Cold. Apply an ice pack (wrapped in a wet cloth) for 10-20 minutes to reduce inflammation.
  • After 48 Hours: Use Heat. Use a heating pad or a hot shower to loosen tight muscles and improve blood flow.

3. Gentle Stretching

  • Have the child gently stretch their arms and shoulders (sets of 10, twice a day). This helps prevent cramps.

If it is Heartburn (Acid Reflux)

1. Antacids

  • Give a liquid antacid (like Mylanta or Tums) as directed on the bottle.
  • Home Hack: If you don’t have medicine, a glass of milk can temporarily soothe the burn.

2. Avoid Triggers

  • Skip the chocolate, soda, caffeine, and spicy foods for a few days.

3. Posture

  • Do not let your child lie down right after eating. Gravity keeps the acid down when they stay upright.
5

⚠️ A Note on Anxiety

A “Worried Stomach” and “Worried Chest” are real. Stress and anxiety can cause physical tightness in the chest. If your child is a “model child” or under stress at school, help them practice relaxation breathing.

Medically Reviewed by Dr Michael Villadelgado
Disclaimer: This information is for educational purposes only. You assume full responsibility for how you use it. If you are unsure, always call your doctor.