Chest pain
Chest pain is common in children and teenagers.
In most cases, it is not serious and can usually be treated with simple pain killers at home.
If your child has any of the following:
- congenital heart disease or previous heart surgery
- previous Kawasaki disease
- a cholesterol disorder
- sickle cell disease
- a history of using stimulating drugs like cocaine
- Family history of arrhythmia, heart disease or sudden death
If your child has severe chest pain and none of the above risks:
- has a very fast or irregular heart rate (palpitations)
- has recently had an accident
- Has had a collapse
- Breathing very fast, too breathless to talk, eat or drink
- Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)
- Breathing that stops or pauses
- Is pale, blue, mottled or feels unusually cold to touch
- Difficult to wake up, very sleepy or confused
- Has a fit (seizure)
- Has a rash that does not disappear with pressure (the ‘Glass Test’)
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If your child has any of the following:
- Has pain that travels to the neck or left shoulder and arm
- Feels faint or dizzy when pain occurs
- Chest pain during exercise
- Chest pain doesn’t go away with simple pain killers
- Chest pain and cough
- Chest pain and fever
- Breathing a bit faster than normal or working a bit harder to breathe
- Dry skin, lips or tongue
- Not had a wee or wet nappy in last 8 hours
- Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)
- Temperature less than 36°C
- Getting worse or you are worried about them
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS 111 - dial 111
If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features
If your child has none of the above
If no red or amber signs, continue to provide self care at home with simple pain killers like paracetamol and ibuprofen.
Watch them closely for any change and look out for any red or amber symptoms
If your child has a long term condition or disability and you are worried please contact your regular team or follow any plans that they have given you.
Self care
Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111
This guidance has been reviewed and adapted by healthcare professionals across North East and North Cumbria with consent from the Hampshire development groups.
Choose appropriate sized spacer with mask (or mouthpiece if child is over 3 years with good technique and is not significantly short of breath).
-
Shake the inhaler well and remove cap.
-
Fit the inhaler into the opening at the end of the spacer.
-
Place mask over the child’s face or mouthpiece in their mouth ensuring a good seal
-
Press the inhaler once and allow the child to take 5 slow breaths between each dose or count to 10
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Remove the inhaler and shake between every puff. Wait 1 minute between puffs.
Repeat steps 1 – 5 for subsequent doses
Plastic spacers should be washed before 1st use and every month as per manufacturer’s guidelines
Choose appropriate sized spacer with mask (or mouthpiece if child is over 3 years with good technique and is not significantly short of breath).
-
Shake the inhaler well and remove cap.
-
Fit the inhaler into the opening at the end of the spacer.
-
Place mask over the child’s face or mouthpiece in their mouth ensuring a good seal
-
Press the inhaler once and allow the child to take 5 slow breaths between each dose or count to 10
-
Remove the inhaler and shake between every puff. Wait 1 minute between puffs.
Repeat steps 1 – 5 for subsequent doses
Plastic spacers should be washed before 1st use and every month as per manufacturer’s guidelines
- Keep your child well hydrated by offering them lots to drink
- Most children with coughs and colds do not require treatment with antibiotics.
- If your child seems to be in pain or discomfort, you can give your child Paracetamol or Ibuprofen, following the instructions on the container.
- Do not give cough syrup. It is not recommended for children under 6 years. It can make children sleepy and does not help.
- Try using saline nose drops or spray if your baby has a blocked nose.
- For children over 2 years, vapour rubs (containing camphor, menthol and/or eucalyptus) may help children sleep better.
Common causes of chest pain in children:
Sometimes we do not know exactly what causes chest pain. Often it happens after coughing and straining of the muscles around the rib cage.
Costochondritis:
Pain over the front of the chest caused by inflammation where the sternum (breast bone) meets the ribs. It can worsen with a deep breath, coughing or if someone presses on the affected area.
What can I do?
A trial of regular Ibuprofen for 2-3 days can reduce the inflammation and pain. Please check the packaging for the doses
Precordial catch syndrome:
Sharp pains in a small area of the chest when breathing in. Due to irritation of the nerves in between the ribs, this normally gets better by itself within a few minutes.
What can I do?
- Most of the time no treatment is needed.
- If it happens again take some slow deep breaths before the pain eases
Acid reflux:
The burning feeling in your chest caused by stomach acid travelling upwards towards the throat. Often there is no obvious reason why this happens but can sometimes be triggered by a virus irritating the stomach lining
What can I do?
- Eat smaller and more frequent meals
- Stay upright for 30 minutes after eating
- Avoid things which worsen the pain: these may include fizzy drinks, acidic, spicy or high fat foods
- Avoid Ibuprofen because this can irritate the stomach lining further
- Contact your doctor if symptoms persist.
Stress and anxiety:
Chest pain or tightness triggered when feeling stressed or worried. Often this can be related to a significant event in a child’s life, or sometimes there is no obvious cause.
What can I do?
- Try to find ways to distract yourself from the discomfort. Visit our anxiety page for guidance
- Speak to someone you trust about your worries
- Visit your doctor if your symptoms persist
Where should you seek help?
- If it is non-urgent, speak to your local pharmacist or health visitor.
- If your child has any of the above features in amber, urgently see your GP. For an urgent out-of-hours GP appointment, call NHS 111.
- You should only call 999 or go your nearest A&E department in critical or life threatening situations or if your child is showing any of the signs in the red section above.
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.
Sound advice
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Some primary and secondary schools may have an allocated school nurse, however this can vary depending on the area – telephone your child’s school to ask for the contact details of your school nursing team.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Some primary and secondary schools may have an allocated school nurse, however this can vary depending on the area – telephone your child’s school to ask for the contact details of your school nursing team.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
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