Thumbnail image of: Pain Diary: Illustration

Chest Pain

What is chest pain?

Your child complains of pain in the chest (front or back).

What causes chest pain?

Most sudden onset, short-term (acute) chest pain is caused by a hacking cough. Coughing can cause sore muscles in the chest wall, upper abdomen, or diaphragm. Heart disease is hardly ever the cause of chest pain in children.

A common cause of recurrent chest pains in adolescents and adults is the precordial catch syndrome. This pain occurs just below the left nipple and comes on suddenly. The pain feels sharp or knifelike, causing the person to not want to move. Usually within 1 minute, the pain is gone. The cause is not known for sure, but it may result from a pinched nerve. Although these pains may come and go for years, the precordial catch syndrome is completely harmless. Daily stretching exercises sometimes reduce these sudden sharp pains.

Acid reflux is another common cause. Heartburn is due to reflux of stomach contents. It usually causes a burning discomfort under the lower sternum (breastbone).

Occasionally a child has chest pain after strenuous exercise, lifting, or work that uses the upper body. This type of muscle soreness often increases with movement of the shoulders.

How can I take care of my child?

Treat sore, strained chest muscles with acetaminophen (Tylenol) or ibuprofen (Advil). Continue this until 24 hours have passed without pain. You can also relieve muscle spasms by putting a heating pad or warm washcloth on the area for 20 minutes. Your child will probably stop having these sore muscle pains within 7 days.

If the pain is caused by coughing, check with your healthcare provider. Coughing helps protect the lungs by clearing out germs.

When should I call my child’s healthcare provider?


  • The pain is severe AND lasts more than 1 hour.
  • Your child is having trouble breathing or is breathing fast.
  • Your child is acting very sick.

Call during office hours if:

  • The chest pain is caused by coughing or pulled muscles AND it persists more than 7 days.
  • Chest pains are a recurrent problem for your child.
  • You have other concerns or questions.
Written by Barton D. Schmitt, MD, author of “My Child Is Sick,” American Academy of Pediatrics Books.
Pediatric Advisor 2015.1 published by RelayHealth.
Last modified: 2011-06-07
Last reviewed: 2014-06-10
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 Barton D. Schmitt, MD. All rights reserved.

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