What is the differential diagnosis for acute sharp chest pain in an 11-year-old female patient in the Emergency Department (ED)?

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Differential Diagnosis for Sharp Chest Pains in an 11-Year-Old Female

Single Most Likely Diagnosis

  • Musculoskeletal Chest Pain: This is the most common cause of chest pain in children and adolescents, often related to strain or overuse of the chest muscles or costochondritis (inflammation of the cartilage that connects the ribs to the breastbone).

Other Likely Diagnoses

  • Asthma or Reactive Airway Disease: Sharp chest pains can be associated with asthma exacerbations, especially if the pain is worsened by breathing or coughing.
  • Pneumonia or Bronchitis: Infections of the lung can cause sharp chest pains, especially if they involve the pleura (the lining surrounding the lungs).
  • Gastroesophageal Reflux Disease (GERD): Stomach acid reflux can cause sharp chest pains, often related to eating or lying down.

Do Not Miss Diagnoses

  • Pulmonary Embolism: Although rare in children, a pulmonary embolism (a blood clot in the lungs) can be life-threatening and must be considered, especially if there's a history of recent trauma, surgery, or family history of clotting disorders.
  • Myocarditis or Pericarditis: Inflammation of the heart muscle or the sac surrounding the heart can cause sharp chest pains and is a medical emergency.
  • Pneumothorax: A collapsed lung can cause sudden, sharp chest pain and is a life-threatening condition that requires immediate attention.

Rare Diagnoses

  • Spontaneous Pneumomediastinum: A rare condition where air leaks into the space around the lungs, causing sharp chest pains.
  • Thoracic Aortic Dissection: A tear in the aorta (the main artery that carries blood from the heart) is extremely rare in children but can be catastrophic if missed.
  • Mitral Valve Prolapse: A condition where the valve between the heart's chambers doesn't close properly, which can cause chest pains, although it's more commonly associated with other symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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