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Chest pain is very common in children and teenagers and, happily, is only rarely associated with heart problems. Chest pains in children and teens are more likely the result of either growing pains, Tietze’s syndrome (costochondritis), respiratory issues, chest wall disorders, or gastroesophageal reflux disease (GERD).

Non-cardiac chest pains include “growing pains”, a dull aching pain localized around the center of the chest. Children frequently have this pain because of muscle strain or injury or, very commonly, spasm in the muscles of the chest. This sort of chest pain usually feels sharp or jabbing, lasts less than a minute, and can occur during exercise or at rest. Chest pain from muscle spasm often is made worse by taking a deep breath, moving a particular way or pressing on the area. It is not associated with difficulty breathing, dizziness, fainting, or a feeling of a racing heartbeat.

Problems with the lungs and windpipe can cause chest pain. Infections of the lining of the lungs can cause fever and pain with breathing (pleurisy). Smoking or infections can cause coughing and pain in the windpipe (trachiitis). Children with asthma or other lung problems seem to have more problems with chest wall muscle spasm, and can also have other chest pains of a more vague nature.

Some people, particularly young women, can develop inflammation in the joints that connect the ribs to the sides of the breast bone (costochondritis), causing pain in this area. Costochondritis, also referred to as Tietze’s syndrome, is an inflammation of the junctions where the upper ribs join with the cartilage that holds them to the breastbone or sternum. Costochondritis is a relatively harmless condition and usually goes away without treatment. The cause is usually unknown.

The most frequent finding with respect to the cause of chest pain in teenagers is tenderness of the chest wall and the most common chest wall disorder is the precordial catch syndrome. In this condition, the pain occurs very briefly for about 30 seconds and the adolescent experiences sharp discomfort beneath the left nipple occurring at rest or with mild activity. Such kind of pain may be caused by poor posture, therefore classrooms and libraries are likely places for it to strike.

Eating too quickly, or eating cold food or food that can get stuck in the esophagus (tube connecting the mouth to the stomach) can cause esophageal spasm, a squeezing pain in the center of the chest that is made worse by swallowing. Heartburn, caused by stomach contents washing up the esophagus can also feel like pain in the chest, particularly to children.

Q: What have your experiences been with growing pains in your children? How did you handle the problem? Have you been diagnosed with a chest pain problem that was not cardiac-related?