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An Unusual Case of Chest Pain in an Adolescent Male: Important Cues to Differential Diagnosis

Jordan, Kathleen S. DNP, RN, MS, FNP-C, SANE-P; Mannle, Sarah E. DNP, FNP-C

Section Editor(s): Ramponi, Denise R. DNP, FNP-C, ENP-BC, FAEN, FAANP, CEN; Column Editor

Advanced Emergency Nursing Journal: January/March 2017 - Volume 39 - Issue 1 - p 10–17
doi: 10.1097/TME.0000000000000135
Imaging

Chest pain is a common presenting symptom in the pediatric population, and in contrast to adults, the etiology is rarely cardiac or life-threatening. The majority of chest pain complaints in children and adolescents are benign and can be managed with reassurance and follow-up. The emergency care provider must obtain a comprehensive history and physical examination, as the differential diagnosis of pediatric chest pain is extensive and serious underlying organic pathology may be present. This article describes the case of an adolescent male with an unusual case of chest pain with a serious underlying medical condition. A systematic approach to the clinical decision-making process is discussed to identify those patients who may have a serious underlying organic cause. Information is also included to guide the provider in the identification of red flags for cardiac etiologies of chest pain and indications for a pediatric cardiology consultation.

The University of North Carolina, Charlotte, North Carolina (Dr Jordan); and Haywood Regional Hospital Clyde, North Carolina (Dr Mannle).

Corresponding Author: Kathleen S. Jordan, DNP, RN, MS, FNP-C, SANE-P, Presbyterian Hospital, Matthew Township Rd, Matthews, NC 28105 (Ksjorda1@uncc.edu).

Disclosure: The authors report no conflicts of interest.

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