When your child complains of chest pain while exercising, you may worry that he has a heart condition. Chest pain due to a cardiac cause is extremely uncommon in children, according to the Cincinnati Children's Hospital. Pain often originates from an injury, illness or asthma rather than from a heart problem. Children who experience chest pain with exertion should be evaluated by a doctor before continuing to exercise or participate in a sport.
Children who have exercise-induced asthma experience difficulty breathing, chest pain, wheezing, coughing, shortness of breath and a tight feeling in the chest during or after exercise. When an asthma attacks occurs, airways in the lung narrow, preventing air from flowing freely through the lungs. The airways also become inflamed and produce excess mucus, which makes breathing more difficult. Activities that increase the rate of breathing, including such sports as running, field hockey and soccer, are more likely to trigger exercise-induced asthma than more moderate activity. Exercising in cold weather may worsen the problem.
Gastroesophageal Reflux Disease
Gastroesophageal reflux disease, or GERD, occurs when the sphincter at the bottom of the esophagus doesn't close completely. The esophagus carries food from your mouth to your stomach. When the sphincter is weak or doesn't close completely, food and stomach acids can re-enter the esophagus, irritating the lining and causing chest pain. Exercise may increase pressure on the stomach and force acids and contents back into the esophagus. Exercising soon after eating can increase the chance of experiencing symptoms if your child has GERD.
Several types of heart problems can cause chest pain during exercise. Conditions that trigger abnormal heart rhythms, such as long QT syndrome, can cause chest pain and even death. Chest pain can also occur if your child has cardiomyopathy, a condition that causes an inflammation of the heart muscle. Dilated cardiomyopathy occurs when the heart muscle is inflamed and enlarged, which affects the heart's ability to pump blood effectively. Other causes of chest pain due to a heart problem include faulty valves in the heart, blood flow obstructions, an abnormality in the coronary arteries or an inflammation of the heart's lining.
Chest pain with exercise can occur after an injury to the muscles or bones in the chest. Costochondritis, a condition that causes painful inflammation in the area between the ribs and breastbone, often happens following an upper respiratory illness. Your child may notice that the area feels tender when she presses on it and may complain of pain when breathing. Pericordial catch syndrome causes pain in the chest or back when your child inhales. The pain only lasts for a few minutes and goes away on its own.
Using an inhaler before exercising and when exercise-induced asthma symptoms occur can help your child manage exercise-induced asthma. If your doctor diagnoses your child with GERD, he may recommend medication to neutralize and decrease stomach acid and heal the lining of the esophagus. Taking beta blockers can help resolve heart rhythm abnormalities due to Long QT syndrome. Doctors use beta blockers, angiotensin-converting enzymes, diuretics and anticoagulants to treat cardiomyopathy. Pacemakers or implantable cardioverter defibrillators can control heart rhythm problems due to cardiomyopathy or long QT syndrome if medication is not effective. Surgery may be needed to replace faulty valves, clear obstructions or address coronary artery abnormalities. Symptoms of both pericordial catch syndrome and costochondritis usually resolve without treatment.
- Cincinnati Children’s Hospital: Chest Pain
- Duke Health.org; Chest Pain in Children and Adolescents; Jennifer S. Li, M.D., M.H.S.; April 30, 2008
- National Heart Lung and Blood Institute: What Is Long QT Syndrome?
- American Heart Association: Cardiomyopathy
- National Digestive Diseases Information Clearinghouse: Heartburn, Gastroesophageal Reflux (GER), and Gastroesophageal Reflux Disease (GERD)