Pediatric Heart Expert Forum
Chest Pain and Shortness of Breath
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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Chest Pain and Shortness of Breath

Hello my name is Danny and i am 15 years old. About a week ago i started to expiernce minor chest pain and discomfort without shortness of breath at night. Then a couple days later i started having some shortness of breath problems again at night. The degree of diffuculty in terms of breathung was not great but over the last couple of nights it has gotten a little worse. Then yestreday and today i started to get minor chest discomfort and shortness of breath during random parts of the day. The pain is not excruciating but it is uncomfortable. The pain also doesnt last very long. I am not exactly in "good" shape and i am a bit overweight, but definently not obese. I have a doctors appointment on monday and if she doesnt find anything should i be worried and get a second opinon? If she gives me suggestions or medicne and it does not help should i be very worried? Do you think it is a heart problem? Is this life threatning? PLEASE HELP ME! HELP WOULD BE GREATLY APRECIATED! Thank you.
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Dear Danny,

Because I am not able to evaluate you myself and I don’t have a lot of information about your chest pain, I am not able to tell you if this is a heart problem, or not.  I can tell you that the majority of chest pain in children is not because of the heart, but is chest wall pain (muscles, bones, etc.).  Frequently, we see shortness of breath with chest pain at rest when there is sharp chest pain that hurts worse when you breathe in.  Adolescents report “shortness of breath” with this, but in reality, it is an avoidance of regular breathing because it hurts.  When you avoid breathing, you feel short of breath.  Typically, reassurance is all we usually need to give for this kind of pain.  Ordinarily, we don’t recommend medications for brief pain, because by the time the medications start to work, the pain is long gone.  Occasionally, if the pain is reproducible by pushing on the chest, we might use a nonsteroidal anti-inflammatory drug, like ibuprofen, for a week to reduce any inflammation that might be occurring.   If your doctor gets a complete history and examination, there should not be a need for a second opinion or concern on your part.

What is more life threatening, though, is that fact that you are overweight and are not in good shape.  This is much more concerning and should be addressed by you, as lack of intervention here will shorten your life.  The biggest things you can do include appropriate dietary and exercise interventions to try to get your weight down and get in better shape.  Realize that these are permanent lifestyle changes, and not something that you would be doing for 1 or 6 or even 12 months.  Dietary interventions including elimination of fast food, fried food, fatty food, and sodas; eating more fruits and vegetables; decreasing dairy fat content to skim or fat-free; using baking, broiling, or steaming for cooking (not frying); and, above all, smaller portion sizes.  A portion size is the size of the palm of your hand, and you only get firsts (no seconds/thirds).  Exercise interventions include doing aerobic exercise (walking, running, swimming, bicycling, basketball, etc.) for 60 minutes on a daily basis.  
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