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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.

When should you worry?

If your child has chest pain and risk factors for a more serious heart condition including:

  • 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)

  • Develops 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 and you are still worried

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 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/or 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 West Yorkshire with consent from the Hampshire development groups.

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.

  • A trial of regular Ibuprofen for 2 to 3 days can reduce the inflammation and pain. Please check the packaging for the dose.
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.

  • Most of the time no treatment is needed.
  • If it happens again, ask your child to take some slow deep breaths until the pain eases.
Acid reflux:

This is a burning feeling in the 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.

  • 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.

  • Try to find ways to distract your child from the discomfort.
  • Encourage your child to speak to someone they trust about their worries. More information can be found on our anxiety page.
  • Visit your doctor if symptoms persist.

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?

All community pharmacies across England are required to be Healthy Living Pharmacies. This means that they are able to offer advice on a range of healthy living matters which includes eating a healthy diet. They can provide information leaflets and give parents, carers and young people more information about other organisations that might also be able to help.

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. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. 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?

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 the child and adolescent mental health services.

 

Contact your local Health Visiting Team:

Bradford Health Visitors or call - 01274 221223

Wakefield Health Visitors or call - 0300 373 0944

Craven Health Visitors or call - 01423 544265

Leeds Health Visitors or call - 0113 843 5683

Calderdale Health Visitors or call - 030 0304 5555 (local rate number)

Kirklees Health Visitors or call - 030 0304 5555 (local rate number)

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

For more information about what Health Visitors do: What does a health visitor do?

School nurses care for children and young people, aged 5 to19, 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

Primary and secondary schools have an allocated school nurse. Phone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Contact your local school nursing team:

Bradford School Nurses 01274 221203

Wakefield School Nurses (0 to 19 service) 0300 373 0944 (local rate number)

Leeds School Nurses 0113 843 5683

Calderdale School Nurses 030 3330 9974 (local rate number)

Kirklees School Nurses 0300 304 5555 (local rate number)

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
  • offering immunisations
  • 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.

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.

All children should be registered with a GP. Anyone in England can register for free with a GP surgery. You do not need proof of address or immigration status, ID or an NHS number.

How to find your local GP.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. 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?

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.

Please note, the online version of NHS 111 is only recommended for children over the age of 5. If your child is under 5 years old, please phone 111.

NHS 111 can also direct you to your nearest urgent treatment centre (minor injuries unit or walk-in centre).

Find your local urgent treatment centre.

When to visit an urgent treatment centre.

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?

A&E departments provide vital care for life-threatening emergencies, such as:

  • loss of consciousness
  • breathing difficulties
  • severe bleeding that cannot be stopped
  • major trauma such as road traffic collisions

If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand. Watch this video with them about going to A&E or riding in an ambulance