Chest Pain in Teen Athletes

Even if an athlete is young and in peak physical shape, chest pain is a symptom that must always be taken seriously. While most bouts of chest pain in children and teens don’t point to a serious heart problem, playing sports can aggravate existing, and sometimes fatal, heart conditions in teen athletes. Since the American Heart Association reports that one in every 30,000 to 50,000 high school athletes will die of sudden cardiac arrest, it’s important to seek medical advice if you think your teen is at risk.
The most common cause of chest pain in children and teens is a catchall condition called chest wall pain, which is painful, but relatively harmless. Chest wall pain can be quite frightening if mistaken for cardiac arrest while an athletic teen is physically exerting himself. It often appears during sporting events when a player is hit or falls and injures his ribs, sternum or other parts of his back and chest. Respiratory infection and bad coughs are other potential causes. Chest wall pain often does not require treatment and will fade away on its own, but teens experiencing chest pain of any kind should see a doctor to rule out a more serious diagnosis.
While the vast majority of teen chest pain is relatively harmless, teenage athletes are susceptible to serious and potentially fatal heart conditions. Vigorous physical activity can exacerbate an undetected heart problem and trigger sudden cardiac arrest. Athletes are more prone to sudden cardiac arrest because they push their bodies harder than sedentary teens who may unknowingly suffer from the same heart abnormalities. Preexisting conditions that lead to fatal cardiac episodes include some types of arrhythmia, Marfan syndrome and, most commonly, hypertrophic cardiomyopathy, which involves the thickening of the walls of the heart.
Although a cardiac arrest related to one of the above conditions may seem sudden, most affected teens experience some symptoms and warning signs. In addition to chest pain, many at-risk teen athletes experience bouts of fainting, dizziness and shortness of breath. If your teen experiences any of these while playing sports, take him to a doctor immediately even if you think there might be another explanation for the symptoms. If anyone in your family has experienced cardiac arrest or a sudden unexplained death, ask your doctor to test your teen for hidden heart defects even if he has yet to experience any chest pain or other symptoms.
The American Heart Association recommends that all young athletes be screened for heart abnormalities before entering any strenuous program of physical activity. Doctors can screen teens for conditions like hypertrophic cardiomyopathy and Marfan syndrome by asking questions about family and personal health history and performing a few physical tests. If there is concern, EKG and echocardiogram tests can usually detect undiagnosed heart conditions. Once diagnosed, teens can talk to their doctors about treatment and whether or not they can continue to play competitive sports.