Child Distress and Chest Pain Linked

Children with chest pains experience higher levels of anxiety and depression

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Few things are as frustrating as having pain and not knowing the cause. That frustration is no less intense for children, including children with chest pain.

But things are not always as they appear. A recent study found that children with chest pain unrelated to heart conditions also have higher levels of anxiety and depression.

There is not evidence to determine that their mental health is causing the chest pain or vice versa. But the researchers have established that there is a link between these children's mental health and chest pains.

"Ask children about their stress levels."

The study, led by Jennifer L. Lee, MS, a doctoral candidate at the University of Georgia, aimed to better understand the conditions of children who had chest pain not linked to a heart problem. The researchers compared 67 children who had non-cardiac chest pain to 62 children who had an innocent heart murmur. A heart murmur is an extra or unusual sound that occurs with normal blood flow in an otherwise normal heart.

Both groups had an average age of 12 (ranging from 8 to 18) and had been recruited from pediatric cardiology offices. Before each child had been diagnosed by the cardiologist, the children and their parents had filled out questionnaires to assess the child's psychological health and how limited they were in performing day-to-day activities.

The results showed that the children with the non-cardiac chest pain had higher levels of anxiety and depression than the children with the heart murmur.

The children experiencing chest pain also reported higher levels of disability in their daily activities and more general physical complaints that appeared related to stress, such as stomach aches, headaches or joint pain. They were less involved in school and after school activities as well.

The researchers therefore concluded that children experiencing chest pain may be also experiencing higher levels of psychological or social stress which should be explored.

"The fact that these psychological symptoms are higher in non-cardiac chest pain patients suggests the psychological symptoms may be playing a role in the presentation of chest pain," Lee said in a release about the study.

That doesn't mean that psychological issues are causing the chest pain. In fact, it could be the other way around – that the chest pain is contributing to more anxiety and depression. The children with the chest pain did not score high enough on the anxiety and depression assessments to be diagnosed with a mental health condition.

However, the researchers noted that the child may need treatment for the stress, anxiety and depression they are feeling regardless of whether they receive treatment for chest pain. The study was published November 5 in the Journal of Pediatric Psychology. The research was funded by the Children's Healthcare of Atlanta Cardiac Research Group. The authors declared no conflicts of interest.

Reviewed by: 
Review Date: 
November 27, 2012
Last Updated:
November 28, 2012