ABSTRACT
Children presenting with dyspnoea usually have other symptoms and signs of respiratory distress syndrome, including tachypnoea, subcostal recession, tachycardia and chest tightness. Asthma can have some shadows in the chest X-ray; these do not indicate pneumonia and will disappear with anti-asthmatic treatment, and antibiotics are not indicated. Chest pain is a common complaint in children. Chest pain in adults is considered a medical emergency because of possible associated heart attack, the overwhelming majority of children have a non-cardiac aetiology. The most common causes of chest pain include idiopathic, injury, musculoskeletal myalgia, pulmonary diseases, cardiac, gastrointestinal disorders and psychogenic causes. Many teenagers present with psychogenic chest pain, often with hyperventilation, reflecting anxiety generated by some events. Chest pain in infancy is difficult to diagnose. Patients with marfanoid appearance and chest pain require close attention because they are at risk of dilatation of the ascending aorta and dissecting aneurysm.
