7 yr. old complains of chest pain

[goatgirl]

My 7 yr. old son first complained of having chest pain last year, during the school year, whenever he would run fast in gym class or during recess.  Since this was not an ongoing complaint and did not seem to occur at home I did not take him to the doctor for this.  I was a little skeptical as to whether or not this was truly pain he was feeling or simply his increased heart beat due to the increase in physical activity, especially since he is so young.  So I made a mental note of his complaint and asked his pediatrician about it during his annual well-child visit last month.  Since he had not been experiencing any recent pain (over the summer) the doctor said to just wait and see how this year went.  Well sure enough last night my son mentioned his chest pain again.  He said when he is running fast he feels pain in his chest that is so painful he has to stop running.  When I asked him if the pain was a tightening, squeezing pain or a sharp pain, he said it was more of a squeezing pain.  I also asked if he found it difficult to breathe or catch his breathe when he felt the pain and he said no.  My son is not typically one to complain about aches and pains, even when warranted, which is why this has me a little concerned.  My son is physically active both at school and home, but perhaps in an effort to keep up with his friends on the playground is running faster then he would normally run during outdoor play at home.  Is it normal for a 7 yr. old to feel pain in his chest while running fast?  Do you think I should take him back to his pediatrician for this pain?  If so, do you recommend any specific type of testing?  

Thank you so much for taking the time to read my question.  I look forward to your response.

[Jeffrey R Boris, M.D.]

Dear Goatgirl,

It is not typical for chest pain to occur with exercise.  Ordinarily, the majority of pediatric chest pain is not because of a  heart-related reason.  However, when it occurs with exercise, it should be taken more seriously.  I would start with your pediatrician and have him/her obtain a history and examination.  If this remains unclear or worrisome, you will likely be referred to a pediatric cardiologist for further evaluation.  Most likely, since this is exercise-related chest pain, a pediatric cardiology evaluation will be necessary.  Typically, an electrocardiogram would be a first test that would be performed.  However, without all of the history and examination information, I cannot recommend which testing needs to be done outside of this.  

[Jeffrey R Boris, M.D.]

Great news--I'm glad that he is well and has no cardiac disease.

[goatgirl]

Thank you so much for responding to my question.  I followed your recommendations and took my son back to see his pediatrician, who then referred us to a pediatric cardiologist.  We saw the pediatric cardiologist last week and thankfully all is well with my son.  The doctor said the pain he was experiencing was just growing pains, most likely caused by under developed pectoral muscles (since he was able to reproduce the pain during our visit) and not anything heart related.  They did do an electrocardiogram on him as well just to be sure and that too was normal.  Thank you again for your advice.