Etiological Evaluation in Children Referred to the Pediatric Cardiology Outpatient Clinic with Chest Pain

Objectives: One of the most common reasons for pediatric cardiology referrals is chest pain in childhood. Although it is mostly innocent in character, it is rarely associated with life-threatening pathologies. In this study, it was aimed to evaluate the etiological causes in children with chest pain.
Methods: Our study included 1000 children who were referred to the pediatric cardiology clinic with the complaint of chest pain between January 2019 and June 2022. Demographic characteristics, accompanying complaints, echocardiographies, electrocardiographies, 24-h rhythm holters, treadmill exercise test, computed tomography angiography, and non-cardiac findings related to etiology were analyzed retrospectively from the file archives of the patients.
Results: Five hundred and nine (50.9%) of the patients were female and 491 (49.1%) were male. The mean age of the patients was 11.3 y (range: 3–18 years). Cardiological pathology associated with chest pain was detected in only 6.8% of the patients. Among the etiologies of chest pain, mitral valve prolapse (MVP) was the most common cardiological pathology with a rate of 2.1%. In the non-cardiac etiological evaluation of chest pain, idiopathic causes with a frequency of 48%, musculoskeletal pathologies with a frequency of 22.6%, respiratory pathologies with a frequency of 7.9%, psychiatric pathologies with a frequency of 7.3%, gastrointestinal pathologies with a frequency of 4.1%, and familial Mediterranean fever with a frequency of 2.4%, miscellaneous with a frequency of 1.1% were found, respectively.
Conclusion: In the study, it was determined that non-cardiac causes were more common among the etiological causes of chest pain in the pediatric age group. In addition, MVP was the most common cause of cardiac chest pain.

Göðüs Aðrýsý ile Çocuk Kardiyoloji Polikliniðine Yönlendirilen Çocuklarda Etiyolojik Deðerlendirme

Giriþ: Çocuk kardiyoloji polikinliklerine en sýk baþvuru nedenlerinden birisi çocukluk çaðý göðüs aðrýlarýdýr. Çoðunlukla masum karakterli olmakla birlikte nadiren hayatý tehdit edebilen patolojiler ile birliktelik gösterebilir. Bu çalýþmada göðüs aðrýsý olan çocuklarda etyolojik nedenlerin deðerlendirilmesi amaçlandý.
Metot: Çalýþmamýza Ocak 2019-Haziran 2022 tarihleri arasýnda çocuk kardiyoloji kliniðine göðüs aðrýsý þikayeti ile yönlendirilen 1000 çocuk dahil edildi. Hastalarýn dosya arþivlerinden demografik özellikleri, eþlik eden yakýnmalarý ekokardiografi, elektrokardiografi, 24 saat ritm holter, efor testi, bilgisayarlý tomografi anjiyografi gibi laboratuvar sonuçlarý ile takiplerinde etyolojiye yönelik tespit edilen diðer bulgular retrospektif olarak incelendi.
Bulgular: Çalýþmaya dahil edilen hastalarýn 509’u (%50.9) kýz, 491’i (%49.1) erkekti. Hastalarýn ortalama yaþý 11,3’tü (aralýk: 3-18 yýl). Hastalarýn sadece %6.8’sinde göðüs aðrýsý iliþkili kardiyolojik patolojiler saptandý. Göðüs aðrýsý etyolojileri içerisinde %2.1 oranla mitral kapak prolabsusu (MVP) en sýk kardiyolojik patolojiydi. Göðüs aðrýsýna yönelik kalp dýþý etyolojik deðerlendirmede sýrasýyla %48 sýklýkta idiyopatik nedenler, %22.6 sýklýkta kas-iskelet sistemi patolojileri, %7.9 sýklýkta solunumsal patolojiler, % 7.3 sýklýkta psikiyatrik patolojiler, %4.1 sýklýkta gastrointestinal patolojiler, % 2.4 sýklýkta ailesel akdeniz ateþi, %1.1 diðer nedenler saptandý.
Tartýþma: Çalýþmada çocuk yaþ grubunda göðüs aðrýsý etyolojik nedenleri arasýnda kalp dýþý nedenler daha sýk tespit edildi. Ek olarak, MVP kardiyak göðüs aðrýsýnýn en yaygýn nedeniydi. (SETB-2023-07-121)