What is the differential diagnosis for a 9-year-old female presenting to the Emergency Department (ED) with chest pain?

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Differential Diagnosis for 9-year-old Female with Chest Pain

Single Most Likely Diagnosis

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

Other Likely Diagnoses

  • Asthma or other respiratory conditions: Asthma, bronchitis, or pneumonia can cause chest pain, especially if the child has a history of respiratory issues.
  • Gastroesophageal reflux disease (GERD): Stomach acid reflux can cause chest pain that may be mistaken for a heart or lung issue.
  • Anxiety or panic disorder: Children can experience anxiety-related chest pain, which may be accompanied by other symptoms like shortness of breath or palpitations.

Do Not Miss Diagnoses

  • Myocarditis or pericarditis: Inflammation of the heart muscle or the sac surrounding the heart can cause severe chest pain and is potentially life-threatening.
  • Pulmonary embolism: Although rare in children, a blood clot in the lungs can cause sudden, severe chest pain and is a medical emergency.
  • Pneumothorax: A collapsed lung can cause sudden chest pain and shortness of breath, requiring immediate medical attention.

Rare Diagnoses

  • Marfan syndrome or other connective tissue disorders: These conditions can increase the risk of aortic dissection or other cardiac issues that may cause chest pain.
  • Tumor or cyst: Rarely, a tumor or cyst in the chest can cause pain, although this is more common in adults.
  • Sickle cell disease: Children with sickle cell disease may experience chest pain due to vaso-occlusive crises, although this is more common in children with known sickle cell disease.

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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