Pediatric Heart Expert Forum
Sharp chest pain
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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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Sharp chest pain

When I was 12, I was diagnosed with sinus tachycardia.. After two ER trips, cardiologist, and heart monitor I was given metoprolol 25 mg once per day. It regulates my heart rate quite well and I haven't had problems in years. I am now nineteen. In the past two weeks, I've been to the ER twice for chest pain. I've had sharp chest pain with an aching arm. The chest pain is persistent but comes and goes. First ER said all blood work and EKG looked great, sent me home and said my meds probably rebounded. Next ER trip said tests, EKG, and X-ray looked good. Make cardiologist there said I may have hurt my arm at work. He said the chances were one in a million that it is my heart causing pain. I went to primary doctor, he said he thinks I have mitrial valve prolapse. My echo showed mild regurgitation. He said not much we can do but if it persist then may try another heart monitor. The problem is the pain is consistent and uncomfortable, any suggestions? I have always known when my heart acted up and it hurts accompanied with arm pain. I really feels it's heart related but wish pain would leave..  
773637_tn?1327450515
Dear LNMW,

Chest pain in pediatric and adolescent patients has a low likelihood of being cardiac in nature (about 4-6%).  You have already had an evaluation that includes an ECG and echocardiogram as well as blood tests that demonstrate that there is not a cardiac reason for your chest pain.  However, chest pain can be caused by lots of other reasons.  If you have persistent chest pain, my first question to you is whether it can be worsened by pushing on your chest.  If you can reproduce or worsen the chest pain, it is chest wall (musculoskeletal) pain, and can typically respond to nonsteroidal antiinflammatory medications, such as ibuprofen.  However, without evaluating you, I cannot say what the actual cause of your chest pain is.  Unfortunately, all you've gotten at this point is what it ISN'T.  It is most certainly not mitral valve prolapse, which is often overdiagnosed and may not actually exist as a true syndrome.  The only thing I can do through this forum is to tell you that it sounds as if this is most likely not your heart causing your pain.
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773637_tn?1327450515
Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
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