Table 1 Noncardiac causes of pediatric chest pain

Musculoskeletal disorders

• Chest wall strain

• Direct trauma/contusion

• Rib fracture

• Costochondritis

• Slipping rib syndrome

Respiratory disorders

• Severe cough

• Asthma

• Pneumonia

• Pneumothorax/pneumomediastinum

• Pulmonary embolism

Psychologic disorders

• Stress-related pain

Gastrointestinal disorders

• Reflux esophagitis

• Esophageal foreign body

Miscellaneous disorders

• Sickle cell crises

• Abdominal aortic aneurysm (Marfan syndrome)

• Pleural effusion (collagen vascular disease)

• Shingles

• Pleurodynia (coxsackievirus)

• Breast tenderness (pregnancy, physiologic)

Idiopathic