At some point during your child’s development, they may complain of chest pain which can be a scary experience for any parent. Fortunately, chest pain in children is rarely due to something serious. Nevertheless, nearly all chest pain, that is anything more than fleeting, requires evaluation either at the ER or by your pediatrician or family physician.

What causes chest pain in children?

Anxiety or stress

Similar to how we can get headaches when we experience emotional stress or anxiety, other parts of our body, including our chests, can react to anxiety or stress with symptoms such as pain.  Anxiety as a source of chest pain is usually a diagnosis of exclusion, meaning all other more serious causes of chest pain must have been ruled out. Your pediatrician may suggest a few tests like an electrocardiogram (EKG) or an echocardiogram (ultrasound of the heart) or blood tests. If the tests show that your child has a healthy heart, it’s possible that anxiety or stress is the root of the chest pain.

If your doctor feels stress or anxiety is the cause of your child’s chest pain, there are many ways to help your child manage their symptoms. For mild cases, reducing extracurricular activities, increasing rest, or teaching relaxation techniques such as breathing exercises or meditation may be all that is needed.  In more significant cases, it might be necessary to consult a child psychologist to get to the root of their anxiety and stress.  It is important to recognize that mental illness can affect brains of any age and it is regrettable to miss out on an opportunity to help a child by not considering this reality.

Your child may be experiencing a consistent, dull pain in the center of their chest which may signal a concern that there is an underlying issue with their heart.  


Costochondritis is inflammation of the cartilage that connects your ribs to your sternum. If your child feels a sharp pain near their sternum, has a tenderness near their sternum, or pain when coughing or taking a deep breath, they may have developed Costochondritis. 

Causes of Costochondritis:

  • Overexercising
  • Performing a strenuous activity
  • Chest injury
  • Respiratory infections

After your pediatrician has determined that your child has Costochondritis, you can usually reduce the pain by using over-the-counter pain relievers, or applying heat or ice to the affected area, and avoiding strenuous activity like exercising or picking up heavy objects.

Gastrointestinal reflux disease (GERD)

GERD (also referred to as acid reflux) is characterized by stomach acid flowing into your esophagus which can cause pain and irritation. One common symptom of GERD is chest pain beneath the sternum. The pain may be particularly bad after eating and drinking certain foods and drinks or while lying down. 

In order to determine if your child has GERD, you must see your pediatrician. During the appointment, they will look for signs of GERD such as an ongoing cough, chest pain, regurgitation of food and drink, and heartburn.  Tests such as lab work or endoscopy might be recommended to confirm the diagnosis.

Treatment includes dietary and behavioral modification around meals and sometimes medication that controls the amount of stomach acid that is produced.

Hiatal hernia

A hiatal hernia occurs when a part of your stomach protrudes through your diaphragm and into your chest. A small opening through the diaphragm is necessary to allow food from your esophagus to your stomach, but a larger opening allows the stomach to bulge through that opening which can cause chest pain. This can even feel like a heart attack with intense squeezing pain in the center of the chest. 

It is also possible for your child to have both GERD and hiatal hernia as they both can result in stomach acid washing up into the esophagus where it doesn’t belong. Your pediatrician can help determine the exact cause of the pain. 

As with GERD, treatment usually involves dietary and behavioral adjustments and sometimes medication.  In rare cases, surgery may be required to stop the herniation.

Heart conditions

While uncommon and not related to heart attacks that adults are prone to, children can experience chest pain that is caused by a heart problem. Heart pain may feel like a pressure or a squeezing pain, and may make your child feel weak or lightheaded. It may be persistent or intermittent.  Due to the possibility that chest pain might be originating from a heart problem, it is important that essentially all chest pain be evaluated by a doctor right away.

Lung conditions

As with heart conditions in children, chest pain caused by the lungs is uncommon.  But, pneumonia, bronchitis, and asthma all occur in children and can cause pain that is worse with deep breathing or coughing.

When Chest Pain In Children Is An Emergency

While all persistent chest pain should be evaluated by a doctor right away, certain features should prompt a visit to the ER.  These include:

  1. Feeling of irregular heartbeat (palpitations) during the pain
  2. Fainting along with the pain
  3. Difficulty breathing while experiencing the pain
  4. Nausea or vomiting along with the pain
  5. Sweats or paleness along with the pain
  6. Pain that is worse with exercise
  7. Becoming easily fatigued around the time the pain started
  8. Swelling of the legs or feet.
  9. Coughing blood

If you have any of these symptoms or any other reason to suspect chest pain is coming from the heart, lungs, or anything serious, don’t hesitate to call 911 or get to the emergency room as soon as you can. You can visit us 24/7 at both of our locations in Bryan and College or give us a call to get help with chest pain for your child.