Concluded Case

Pediatric Central Chest Pain

9 year old FCH Presented with Central chest pain of acute onset. H/O similar episodes before . 1 year back consulted cardiologist and done an echo , came to be normal . Child has H/O increased sweating and tension .No h/O vomitting , headache, fever , joint pain F/h/O -father - Mild MR and ?AR ( details not available) on anti HTN O/E - Tenderness + No murmur HR -on the lower side - 40-50, then increased to 65 EKG attached

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Concluded answer
Changes in V1 V2 , advised review ...no further symptoms ...possibly Gastritis with insignificant EKG changes.
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T wave inversion in lead V1 and v2 otherwise normal ecg . Need further evaluation like TMT , 2D echo test
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Normal ecg, Anxiety neurosis, short course of anxiolytic like Alprazolam.
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Pl ADD . T INVERSION V1 ---V 3 AT HER AGE IS NORMAL RAD IN ECG Local.TENDERNESS may BE = costochondritis Echocardium may help to EXCLUDE M V P Variation in heart rate may be NORMAL Look FOR SSS
H/o increased sweeting suggest s there may b some problem.An angio should be done. Aortic problems may be again reviewed in ECHO. May be we can get the diagnosis.
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Changes in V1 V2 , advised review ...no further symptoms ...possibly Gastritis with insignificant EKG changes.
Normal for his/her age Ischemia is very very rare at this age If Echo is normal than think of non Cardiac reason
ECG T wave inversion in V2 V3, QRS complex increased In V5, ??Cardilogist opinion
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Normal ecg.may be a musculoskeletal cause since local tenderness is present.
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T wave inversion in V1 ,V2 advice echo for further normal ecg
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LVH with LV strain pattern .....control BP if I s high
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