Pain in the region of the heart in children are one of the frequent reasons for seeking medical attention. Doctor it is important to specify their localization, time of appearance, consistency or sporadically morbid phenomena, intensity, distribution, communication with physical pain or emotional stress and other factors. It is important to establish cause and relieve any pain factors.
Pain in the heart in children are mostly magical in nature (86,9%), localized in the apex of the heart (96,1%), triggered by a stressful situation (79,6), not radiating, not associated with physical activity, are reduced or disappear when the distraction of the child, and after taking sedatives.
Causes of heart pain in children
1. Heart pain in children most often have functional and generally can not be associated with pathology of the heart. Cardialgia in children of early school age are usually the manifestation, the so-called growing pains, when intensive growth of the heart muscle exceeds growth of blood vessels supplying the organ.
These pains occur usually astening, emotional, moving children with exercise, fast walking or running. Come in to stay, relax, calm down, and the pain goes away. Such cardialgia usually stabbing nature, may be repeated not once, but periodically over several months.
2. Heart pain in adolescence is usually associated with impaired autonomic regulation of the heart, are a manifestation of vegetative-vascular dystonia. Pain in the heart when the IRR too often thrusting nature localized in the left half of the chest, left arm, can occur at rest.
3. Very often the child’s pathology of other organs and systems feigns pain in my heart. First is the pathology of the spine (scoliosis, early osteochondrosis) . In second place pathology of the nervous system (neurosis, etc.) Finally, the pathology of the gastro-intestinal tract (biliary dyskinesia, cholecystographic). Typical for children is the inability to properly localize the source of pain. So, for example, pain in the abdomen, a small child might show on a chest, heart area.
Sharp pain when breathing, coughing or other respiratory movements usually indicate the pleura and pericardial area or the mediastinum as a possible source of the pain, although the pain in the chest wall, probably also influenced by respiratory motion. Similarly, the pain that occurs regularly while walking and disappears after a few minutes after stopping, is still considered a typical symptom of angina, although such phenomena may be observed in patients with disorders and injuries of the skeleton.
5. We should pay particular attention if the pain in my heart, the child appears on the background of current acute diseases (SARS, influenza) that may indicate the development of viral myocarditis. And also, if the pain occur after 2-3 weeks after suffering a sore throat or scarlet fever. Through this time after a streptococcal infection starts rheumatism. When such grave complications like myocarditis and rheumatism, besides pain in the heart to disturb other complaints: signs of intoxication, malaise, joint pain, irregularities in heart etc. In this situation, you should promptly consult a doctor.
6. Associated with damage to the heart cardialgia observed in children with anomalous coronary circulation, pericarditis, sudden enlargement of the heart or great vessels. When the anomalous coronary origin of the left coronary artery from the pulmonary syndrome of Blanda-white-garland) pain squeezing, squeezing, localized behind the breastbone that may radiate to neck, jaw, shoulders.
7. Postcardiotomy syndrome. Dull pain in the chest, fever, arthralgia appear a few weeks after the operation, accompanied by the opening of the cavity of the heart, in 30% of operated children. The characteristic expansion of borders of heart, increased ESR, increased antibodies to heart muscle in the blood that is seen as a hyperergic reaction of an organism to damage of cardiac muscle cells.
8. When pericarditis can be two types of pain in the heart. Pleural pain associated with respiratory movements and exacerbated by coughing and (or) deep breath that caused pleuritic component of infectious pleuropericarditis. The second type of pericardial pain is an oppressive chest pain that mimic myocardial infarction or angina. Due to the pain inflammation of the sensitive internal parietal surfaces of the pericardium or irritation of the afferent nerve fibers of the heart, lying in periadventitial the surface layer of the coronary arteries. The pain caused by pericarditis, usually expressed as a feeling of pressure. It occurs when infectious or rheumatic pericarditis. The intensity of the pain varies from mild to sharp, pain increases with movement, deep breath. During the transition in dry pericarditis pericardial pain stop, at the same time appear muted tones of the heart, venous stasis, the triangular shadow of the mediastinum.
Dull constant pain in the heart, sometimes with a strong sense of tingling and pain that radiates to the left arm and shoulder, as in angina pectoris, can be caused by myocarditis or pericarditis due to acute expansion of the heart. If the pain is combined with friction noise, synchronous with the heart beats, visible venous congestion in the neck veins and hepatomegaly should think about pericarditis (characteristic x-ray configuration of the heart).
9. It is a mistake to assume that pain in the heart of a child is a manifestation of the defect. Congenital heart disease often have other clinical signs.
Cardialgia observed in lesions of major blood vessels – primarily in primary pulmonary hypertension, the development of aneurysms in the pathology of the aorta (Marfan syndrome, nonspecific aortoarteriit, etc.), pulmonary embolism, etc. As the cause of pain in the heart coronary vessels in children is rare and is observed in the anomalies of the coronary vessels, congenital heart defects (tetralogy of Fallot, aortic stenosis, transposition, anomalous origin of the left coronary artery from the pulmonary artery), when coronarita on the background of SLE, nonspecific arteritis, periarteritis nodosa, rheumatic fever, non-rheumatic carditis, infective endocarditis.
What doctors to go if there is a pain in the heart children:
If the pain in the heart occurs in apparently healthy child, but repeated many times, and the child sharpens on her account, that is, the need to visit the pediatrician or pediatric cardiologist. It is possible that after heart tests (EKG And ultrasound) will need to see other specialists – neurologist, orthopedist, gastroenterologist.