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4 year old with intermittent chest pain
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4 year old with intermittent chest pain

My 4 year old son first told me a few weeks ago that sometimes his "heart hurts" when he runs or walks. I asked how long it had been going on and he seemed to think for a while. I told him to tell me if he ever felt them again. Since then he's had 3-4 episodes of chest pain immediately after running or playing hard (but he has also run and not had pain). I asked him to describe the pain and he said "hard". Later he described it as a tickle feeling. All of these pains were on the left side of his chest. He had one time where he felt it on the right side, and one time he felt pain after lying down. As an aside, he has also been tiring very easily lately, not keeping up at play like he used to, and even unable to do some things (like lift himself out of the pool with his elbows) that he's been doing routinely for a long time. Seems to breathe harder than normal when exerting himself.  

Took him to his doctor who referred him to the pediactric cardiologist (who he saw last year for a heart murmur which was found to be innocent) since his doctor heard the murmur again and just wants to rule things out re: the chest pains.

I'm wondering if I'm jumping the gun since he only has had a handful of episodes, but he's so tired lately I'm wondering if the symptoms could be related. But could anything heart-related have developed in the past year since when he had a normal echo?

Thank you in advance for any insight you may have.

Avatar_dr_m_tn
Hey nbw07,

It is difficult for anyone to make a diagnosis over the internet without examining the patient but I can give you some advice which may be of help.

From what you have described, the symptoms appear to be rather non specific, which means that the symptoms may not particularly be from the heart. However, that being said, if the doctor who examined your son felt that he should be seen by a pediatric cardiologist, he should be evaluated by one.

I would be particularly concerned if he has a history of a murmur. It is very possible that this is/ was a benign murmur of no major clinical significance but I think we should ensure that is indeed the case.
Children of your son's age grow rather quickly and anatomy changes accordingly.
I dont think that you are "jumping the gun." Even if the testing comes out all negative for a major cardiac problem, reassurance cannot hurt anyone.

Hope that helps
2 Comments
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Avatar_f_tn
Thank you. I really don't feel it's heart related but I do think it's a good idea to rule it out. However, I don't want to waste the cardiologist's time (or the insurance co's $$) if there's no way anything could be wrong following a normal echo a year ago.

Thanks for answering my question and confirming the follow-up.
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