September 26, 2001
Aches and Pains
Question from Pal Harbor, Florida, USA:
My six year old son, diagnosed at the age of two, is complaining of chest pains. About eight months ago, it was very infrequent (about 5 times in several months), but now it is occurring more often, around three to five times a week, sometimes twice in an evening. When he feels this, he clutches at his chest and runs to me, fearfully. It is not necessary precipitated by activity, as it can come when he is sitting watching TV. The pain is very transient, attacks lasting not more than a minute. I tell him to take deep breaths, but I am scared and so is he when this happens.
My opinion is that it looks like a muscular spasm, but I would like to follow through with this to rule out any congenital anomalies. What kind of diagnostics should we look at?
Answer:
I can certainly imagine how these spells are frightening. Fortunately, it would be unlikely for this to be serious or related to his diabetes, especially given the nature of the spells that you describe. Most causes of chest pain in children (regardless of whether or not there is diabetes) are not related to heart disease. Chest pain is usually muscular in nature or sometimes actually reflects a variation of asthma. This type of pain can occur in a congenital heart condition called mitral valve prolapse which is usually not associated with serious events.
I think that it would not be unreasonable to request a referral to a pediatric cardiologist to consider an echocardiogram. Keep an open dialogue with your pediatrician.
DS
