While heart disease is rare in teenagers and young people, if your teen has pain or pressure in the chest, it’s important to know how to respond.
“Symptoms that indicate a potential heart issue, including pain or pressure in the chest, are also symptoms of conditions that have nothing to do with the heart,” said Laura M. Shopp, MD, a pediatric cardiologist at Riley Children’s Health. “We become concerned about heart problems when chest pain or pressure is sudden or intense, or when it happens during exercise or physical activity. In these cases, immediate medical attention is required.”
Causes of chest pain not related to the heart
Many conditions can cause chest pain or pressure. Some of the most common issues that don’t involve the heart include:
- Chest muscle strain – “There are a lot of muscles in the chest wall and between the ribs that can cause pain and pressure, especially for teens who are very active or those who are just starting to become more physically active,” said Dr. Shopp.
- Lung issues – “It’s common for lung and breathing issues, such as asthma, to cause chest pressure and discomfort,” Dr. Shopp explained. “Heavy breathing from more strenuous physical activity can also cause these symptoms.”
- Acid reflux and heartburn
“Your child’s pediatrician or primary care doctor is the best place to start in evaluating chest pain that’s not an emergency,” Dr. Shopp advised. “They are trained to screen for all types of conditions, including heart problems.”
To determine what’s causing the pain, your pediatrician will likely ask your child:
- What symptoms are you experiencing?
- How intense are the symptoms?
- When do they happen?
- How long do they last?
- What makes the pain/pressure better? What makes it worse?
The initial appointment will also include a medical history focused on identifying heart disease that runs in the family. If a heart issue is suspected, there are simple, noninvasive tests that can be performed to diagnose potential problems. These tests include an electrocardiogram (EKG), which usually can be performed in your pediatrician’s office.
An echocardiogram, or heart ultrasound, is another procedure that can be completed to help detect heart abnormalities. Echocardiograms are typically performed in cardiology offices or hospitals and interpreted by pediatric cardiologists.
Conditions that pediatricians and pediatric cardiologists are looking for with these diagnostic tests, include:
- Issues with your child’s heart rhythm (arrhythmia)
- Undiagnosed congenital heart disease (a heart condition present at birth)
- Undiagnosed cardiomyopathy (heart muscle disorder that affects the heart’s ability to pump blood)
- Inflammatory heart conditions (myocarditis or pericarditis that can be caused be infection)
“If your child develops chest pain or pressure following an illness, it’s important to consult your pediatrician or primary care doctor to rule out any cardiac inflammation,” Dr. Shopp said.
Keeping your teen’s heart healthy
While heart disease is uncommon early in life, the obesity rate for children and adolescents in the United States is concerning.
“About one-third of children and teenagers are either overweight or obese,” Dr. Shopp said. “Obesity puts children at risk for a variety of health problems, including high blood pressure, high cholesterol and diabetes—all of which can cause heart disease later in life.”
A healthy diet and exercise, along with regular checkups with a pediatrician or primary care physician are important at every stage of life, but especially as children are growing into young adulthood and learning to take care of themselves.
Dr. Shopp, a physician with the Preventive Cardiology Program at Riley Children’s, encourages children and teens to follow the 5-2-1-0 approach every day—5 or more fruits and vegetables, no more than 2 hours of screen time, at least 1 hour of physical activity and 0 sugary beverages. As part of an overall prevention plan, the American Academy of Pediatrics recommends universal cholesterol screening for children between the ages of 9 and 11 and then again between ages 17 and 21. Children with a family history of heart disease can be screened as early as age 2.
“High cholesterol, a major cause of heart disease, has no symptoms, and we know that cholesterol can change during puberty, so screening both before adolescence and later in the teen years is so important for maintaining good heart health,” Dr. Shopp said. “Emphasizing a healthy lifestyle—using 5-2-1-0 or another approach that promotes a balanced diet and exercise—can go a long way in addressing some of the health concerns we have about future heart disease for children and teenagers.”