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Clinical Pediatrics, Vol. 29, No. 7, 374-377 (1990)
DOI: 10.1177/000992289002900702

Chest Pain in Children

Follow-up of Patients Previously Reported

Steven M. Selbst

Emergency Department, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104

Richard Ruddy

New York Medical College

B.J. Clark

Division of Cardiology, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

During a 1-year period, 407 children with chest pain were seen in the Emergency Department of Children's Hospital of Philadelphia. Analysis of the clinical data of these children was reported previously. The authors successfully followed 149 of these children for 6 months or more, and 51 for 2 years or more. These patients returned for an average of 3.4 visits during the follow-up period.

Thirty-four percent of the initial diagnoses were altered. Usually, during the follow-up period, the authors concluded that chest pain resulted from nonorganic causes. A new organic etiology was uncovered in only 12 of 149 cases. Only 1 child was found to have a heart abnormality (mitral valve prolapse), and 3 were found to have asthma.

Chest pain did not resolve during the follow-up period in 43 percent of those followed. Children with chest pain should have follow-up care because of the persistence of symptoms, but serious disease is unlikely to be found over time.


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