Pediatric Heart Expert Forum
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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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What is going on?

I am a 16 year old male. I weight 120 pounds and am 5'9. Since march I have been getting chest pain, shortness of breath and dizziness. It can last anywhere from 5 minutes to 5 hours. I have seen quite a few doctors(mostly ER doctors and one pediatritian) I had an Echo, chest x-ray and stress test. all were normal but for the stress test I only ran for about 4 minutes before having to stop due to shortness of breath, but no pain anywhere. The doctor said someone my age should have run for 10 to 16 minutes and not get tired. I'm still worried if it could something with my heart and know has given me a diagnoses yet. All they said is we can't find anything wrong. THe pain I get is somtimes a burning pain and somtimes a tight squezing pain and it's kind of in between my chest and abdomen. I just want to know what this could be, and what are the chance of it being a heart attack and what the doctor could have meant when he said I should have been able to run longer or what it could be a sign of. The ecg was normal and i got to 85% of my target heart rate.

Thanks in advance.

P.S. the pain tends to get worse when i stand up or walk but isn't triggered by exersise.
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773637_tn?1327450515
Dear Philip,

Because I am not able to evaluate you myself and I don’t have enough 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.   Usually, pediatric cardiologists like to get patients to 100% of predicted heart rate, not 85%, so the results of your stress test are not totally helpful for me, either.  I do not know if you are physically active, or not, as this could be evidence of deconditioning, as well.  Finally, the dizziness could be either from mild dehydration or hyperventilation.  Overall, you need to see someone who can sort all of this out with you by history and examination.
3 Comments
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Avatar_m_tn
I also forgot to mention my heart rate is about 100-120 during these episodes.
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Avatar_m_tn
Thank you dr. Boris. I have seen a lot of different doctors each with different answers. Some think it's GERD others think it chest wall pain and some think it's anxiety.
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Marie M Gleason, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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Jeffrey R Boris, M.D.Blank
The Children’s Hospital of Philadelphia
Philadelphia, PA
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