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Successful completion of treadmill testing provides relief and reassurance for children with non-specific chest pain

Published online by Cambridge University Press:  12 December 2022

Irem Turkyilmaz Open the ORCID record for Irem Turkyilmaz [Opens in a new window] ,
Burcin Ozlem Ates ,
Mehmet Ayhan Congologlu  and
Ayhan Kilic
Irem Turkyilmaz*
Affiliation:
SBU Gulhane Education and Research Hospital, Department of Pediatric Cardiology, Ankara, Turkey
Burcin Ozlem Ates
Affiliation:
SBU Gulhane Education and Research Hospital, Department of Child & Adolescent Psychiatry, Ankara, Turkey
Mehmet Ayhan Congologlu
Affiliation:
SBU Gulhane Education and Research Hospital, Department of Child & Adolescent Psychiatry, Ankara, Turkey
Ayhan Kilic
Affiliation:
SBU Gulhane Education and Research Hospital, Department of Pediatric Cardiology, Ankara, Turkey
*
Author for correspondence: Irem Turkyilmaz, Gulhane Education and Research Hospital, Department of Pediatric Cardiology, 06010 Ankara, Turkey. Tel: +90 312 304 6756. E-mail: iremtyilmaz@gmail.com
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Abstract

Objective:

Non-specific chest pain is one of the leading causes of admissions in paediatric cardiology outpatient clinics, and its management usually consists of extensive reassurance of patients and their families. As we have often observed that successful completion of treadmill testing during diagnostic work-up provides relief and reassurance in these patients and their families, we planned this study to quantitatively assess anxiety levels and perception of illness among children with non-specific chest pain before and after treadmill testing.

Method:

We studied 50 children (aged 11.8 ± 3.0 years, range 7–17 years; 24 females, 26 males) with a chief complaint of non-specific chest pain and negative history and echocardiography. They were asked to fill the Revised Children’s Anxiety and Depression Scale before the treadmill testing and 1–10 days after successful completion of treadmill testing.

Results:

Average total anxiety scores (36.38 ± 19.09 versus 33.36 ± 19.09, respectively) and average of total anxiety + depression scores (44.3 ± 24.92 versus 40.8 ± 26.97, respectively) of the children were found to be significantly lower after negative treadmill testing as compared to scores before testing (p < 0.05). Alterations in separation anxiety, panic, social phobia, obsession-compulsion scores were not statistically significant (p > 0.05).

Conclusion:

Children with non-specific chest pain feel relieved and reassured after successful completion of treadmill testing. To the best of our knowledge, our study is the first in the literature to show this relationship quantitatively.

Keywords

Treadmill testanxietychest painchildren
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 10 , October 2023 , pp. 2012 - 2015
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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References

Aygun, E, Aygun, ST, Uysal, T, Aygun, F, Dursun, H, Irdem, A. Aetiological evaluation of chest pain in childhood and adolescence. Cardiol Young 2020; 30: 617–623. DOI 10.1017/S1047951120000621.CrossRefGoogle ScholarPubMed
Lipsitz, JD, Masia-Warner, C, Apfel, H, et al. Anxiety and depressive symptoms and anxiety sensitivity in youngsters with noncardiac chest pain and benign heart murmurs. J Pediatr Psychol 2004; 29: 607–612. DOI 10.1093/jpepsy/jsh062.CrossRefGoogle ScholarPubMed
Anwar, S, Kavey, RE. Pediatric chest pain. Clin Pediatr 2012; 1: 659–662. DOI 10.1177/0009922812440842.CrossRefGoogle Scholar
Shaddy, RE. Moss & Adams' Heart Disease in Infants, Children, and Adolescents. 10th edn. Wolters Kluwer, Wolters Kluwer Health, 2021, 1599,Google Scholar
Chorpita, BF, Yim, L, Moffitt, C, Umemoto, LA, Francis, SE. Symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale. Behav Res Ther 2000; 38: 835–855. DOI 10.1016/s0005-7967(99)00130-8.10.1016/S0005-7967(99)00130-8CrossRefGoogle ScholarPubMed
Gormez, V, Kilincaslan, A, Orengul, AC, et al. Psychometric properties of the Turkish version of the revised child anxiety and depression scale - child version in a clinical sample. Child Psychiatry Hum Dev 2017; 27: 84–92. DOI 10.1007/s10578-017-0716-1.Google Scholar
Rohani, A, Akbari, V, Zarei, F. Anxiety and depression symptoms in chest pain patients referred for the exercise stress test. Heart Views 2011; 12: 161–164. DOI 10.4103/1995-705X.90903.10.4103/1995-705X.90903CrossRefGoogle ScholarPubMed
Evangelista, JK, Parsons, M, Renneburg, AK. Chest pain in children: diagnosis through history and physical examination. J Pediatr Health Care 2000; 14: 3–8. DOI 10.1016/s0891-5245(00)70037-x.10.1016/S0891-5245(00)70037-XCrossRefGoogle ScholarPubMed
Pissarra, R, Pereira, M, Amorim, R, Neto, BP, Lourenço, L, Santos, LA. Chest pain in a pediatric emergency department: clinical assessment and management reality in a third-level Portuguese hospital. Porto Biomed J 2022; 17: e150. DOI 10.1097/j.pbj.0000000000000150.CrossRefGoogle Scholar
Yildirimcakar, C, Omay, O, Açar, B, et al. Assessment of cardiovascular surgery requirements in children and adolescents admitted with chest pain to a pediatric emergency clinic. Heart Surg Forum 2022; 25: 168–E174. DOI 10.1532/hsf.4341.CrossRefGoogle ScholarPubMed
Lipsitz, JD, Masia, C, Apfel, H, et al. Noncardiac chest pain and psychopathology in children and adolescents. J Psychosom Res 2005; 59: 185–188. DOI 10.1016/j.jpsychores.2005.05.004.CrossRefGoogle ScholarPubMed
Tunaoglu, FS, Olgunturk, R, Akcabay, S, Oguz, D, Gucuyener, K, Demirsoy, S. Chest pain in children referred to a cardiology clinic. Pediatr Cardiol 1995; 16: 69–72. DOI 10.1007/BF00796820.10.1007/BF00796820CrossRefGoogle ScholarPubMed
McDonnell, CJ, White, KS, Grady, RM. Noncardiac chest pain in children and adolescents: a biopsychosocial conceptualization. Child Psychiatry Hum Dev 2012; 43: 1–26. DOI 10.1007/s10578-011-0240-7.CrossRefGoogle ScholarPubMed
Milov, DE, Kantor, RJ. Chest pain in teenagers: when is it significant? Postgrad Med 1990; 88: 145–148. DOI 10.1080/00325481.1990.11716397.CrossRefGoogle ScholarPubMed
Zavaras-Angelidou, KA, Weinhouse, E, Nelson, DB. Review of 180 episodes of chest pain in 134 children. Pediatr Emerg Care 1992; 8: 189–193. DOI 10.1097/00006565-199208000-00004.CrossRefGoogle ScholarPubMed
Hambrook, JT, Kimball, TR, Khoury, P, Cnota, J. Disparities exist in the emergency department evaluation of pediatric chest pain. Congenit Heart Dis 2010; 5: 285–291. DOI 10.1111/j.1747-0803.2010.00414.x.10.1111/j.1747-0803.2010.00414.xCrossRefGoogle ScholarPubMed
Hiscock, H, Connolly, AS, Dunlop, K, et al. Understanding parent-reported factors that influence children and young people’s anxiety and depression presentations to emergency departments: a multi-site study. Emerg Med Australas 2020; 32: 724–730. DOI 10.1111/1742-6723.13486.CrossRefGoogle Scholar
Kenar, A, Orun, UA, Yoldas, T, Kayali, S, Bodur, S, Karademir, S. Anxiety, depression, and behavioural rating scales in children with non-cardiac chest pain. Cardiol Young 2019; 29: 1268–1271. DOI 10.1017/S1047951119001896.10.1017/S1047951119001896CrossRefGoogle ScholarPubMed
Akrivopoulou, G, Gkentzi, D, Fouzas, S, Vervenioti, A, Dimitriou, G, Karatza, AA. Parental anxiety and misperceptions in children with innocent murmurs. Pediatr Int 2021; 63: 1170–1174. DOI 10.1111/ped.14664.10.1111/ped.14664CrossRefGoogle ScholarPubMed
Selbst, SM, Ruddy, RM, Clark, BJ, Henretig, FM, Santulli, T Jr. Pediatric chest pain: a prospective study. Pediatrics 1988; 82: 319–323.10.1542/peds.82.3.319CrossRefGoogle ScholarPubMed
Lipsitz, JD, Gur, M, Albano, AM, Sherman, B. A psychological intervention for pediatric chest pain: development and open trial. J Dev Behav Pediatr 2011; 32: 153–157. DOI 10.1097/DBP.0b013e318206d5aa.10.1097/DBP.0b013e318206d5aaCrossRefGoogle ScholarPubMed
Rowe, BH, Dulberg, CS, Peterson, RG, Vlad, P, Li, MM. Characteristics of children presenting with chest pain to a pediatric emergency department. CMAJ 1990; 143: 388–394.Google ScholarPubMed
Kaden, GG, Shenker, IR, Gootman, N. Chest pain in adolescents. J Adolesc Health 1990; 12: 251–255. DOI 10.1016/0197-0070(91)90019-.CrossRefGoogle Scholar
Pantell, RH, Goodman, BW Jr. Adolescent chest pain: a prospective study. Pediatrics 1983; 71: 881–887.CrossRefGoogle ScholarPubMed