Chest pain and syncopes

Are luckily hardly ever a sign of a cardiac problem. To differentiate the most common causes ask following questions:

Cardiac danger signs requiring further work-up:

• Syncope upon excercise
• History of edema, palpable arrythmias, signs of heart failure with syncope
• Family history of recurrent syncopes or sudden death

a) signs for intercostal neuralgia pains

• pain increases on inspiration and/ or movement
• pain is localized between the ribs usually only on one side

b) signs for uncomplicated syncope

• collapse upon getting up from lying/ standing position
• can also be caused by sudden pain or sudden strong emotions or urinating/ defecating
• usually more frequent at times of hot weather and in the teenage age group
• more frequent if child as not eaten or especially has not drank anything in the morning
• does not happen during exercise unless child has completely worn itself out