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Suggest Remedy For Chest Pain, Breathlessness And Belching In A Child
Question: My 13 year old has been having chest pains, shortness of breath, belching, and heavy feelings in his chest for 2 days. he was at the emergency room last night and had an ekg which was normal. he says right now his left arm hurts too. He did a breathing test which turned out normal and his vitals were normal. we're supposed to follow up with his pediatrician tomorrow. It is still occurring. He has had intermittent chest pain for a few months now. what is this??
seems to be brought on by food too
seems to be brought on by food too
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I read carefully your question and would explain that his symptom don't seem to be cardiac related. His normal ECG and vital signs can confirm this.
it is important to perform a careful differential diagnosis between different causes of chest pain:
-a backbone disorder, which would also explain the arm pain (irradiating nerve pain)
-inflammation or costochondritis which could mimic this symptomatology
-a hiatal hernia or esophageal spasms could explain the chest pain and belching
-an lung disorder (this has been excluded by the performed tests)
-a cardiac disorder (this has been excluded by the performed tests)
-anxiety and a panic attack could also mimic this clinical scenario.
Is his chest pain modulated by respiration or body movements? This would be more indicative of a musculoskeletal issue.
I recommend consulting with his pediatrician and perform a careful physical exam and some tests :
-a cervico-thoracic spinal column X ray study
-a chest X ray study
-blood lab test (complete blood count, fasting glucose, kidney and liver function tests, blood electrolytes, PCR, sedimentation rate)
-a fibrogastroscopy to exclude possible gastro esophageal disorders.
You should discuss with his attending physician on the above issues.
Hope to have been helpful!
Feel free to ask an other questions whenever you need!
Best wishes!
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I read carefully your question and would explain that his symptom don't seem to be cardiac related. His normal ECG and vital signs can confirm this.
it is important to perform a careful differential diagnosis between different causes of chest pain:
-a backbone disorder, which would also explain the arm pain (irradiating nerve pain)
-inflammation or costochondritis which could mimic this symptomatology
-a hiatal hernia or esophageal spasms could explain the chest pain and belching
-an lung disorder (this has been excluded by the performed tests)
-a cardiac disorder (this has been excluded by the performed tests)
-anxiety and a panic attack could also mimic this clinical scenario.
Is his chest pain modulated by respiration or body movements? This would be more indicative of a musculoskeletal issue.
I recommend consulting with his pediatrician and perform a careful physical exam and some tests :
-a cervico-thoracic spinal column X ray study
-a chest X ray study
-blood lab test (complete blood count, fasting glucose, kidney and liver function tests, blood electrolytes, PCR, sedimentation rate)
-a fibrogastroscopy to exclude possible gastro esophageal disorders.
You should discuss with his attending physician on the above issues.
Hope to have been helpful!
Feel free to ask an other questions whenever you need!
Best wishes!
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you so much. does chest pain modulated by respiration or movement mean....it is worse, or bad when he breaths or moves? Is that what you're asking? If so...yes. He says standing after laying he can feel the chest pain, breathing deep breaths and bending forward like to tie a shoe. that's when he feels the pain too. please reply
Brief Answer:
Explaining as follows:
Detailed Answer:
Hello again,
Yes! With modulated by respiration or movement, means exactly what you explained.
Coming to this point a musculoskeletal disorder is highly suspected.
Also pleural or pericardial layers inflammation should be considered suspected as well.
I advise to check the above recommended medical tests and also a cardiac ultrasound to investigate for a possible pericardial inflammation.
This clinical condition is not life-threatening.
So, relax!
Any anti-inflammatory drugs like ibuprofen, naproxen, etc. could result highly beneficial in relieving the pain.
You need to discuss with his pediatrician about the above mentioned issues.
I wish a good health for you and your soon!
Kind regards,
Dr. Iliri
Explaining as follows:
Detailed Answer:
Hello again,
Yes! With modulated by respiration or movement, means exactly what you explained.
Coming to this point a musculoskeletal disorder is highly suspected.
Also pleural or pericardial layers inflammation should be considered suspected as well.
I advise to check the above recommended medical tests and also a cardiac ultrasound to investigate for a possible pericardial inflammation.
This clinical condition is not life-threatening.
So, relax!
Any anti-inflammatory drugs like ibuprofen, naproxen, etc. could result highly beneficial in relieving the pain.
You need to discuss with his pediatrician about the above mentioned issues.
I wish a good health for you and your soon!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you again. am writing this down for his pediatrician. last question. what about the large, frequent belching? how would that fit in to for example plural or pericardial inflamation? thanks
Brief Answer:
A comprehensive differential diagnosis should be done.
Detailed Answer:
Hi,
Belching seems to be related to a digestive disorder (reflux, etc).
As I explained you before a gastro-esophageal investigation should be part of the differential diagnosis workup.
Only after following a comprehensive diagnostic process could be arrived to the right responsible cause(s).
Regards,
Dr. Iliri
A comprehensive differential diagnosis should be done.
Detailed Answer:
Hi,
Belching seems to be related to a digestive disorder (reflux, etc).
As I explained you before a gastro-esophageal investigation should be part of the differential diagnosis workup.
Only after following a comprehensive diagnostic process could be arrived to the right responsible cause(s).
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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