Lack of familiarity with a systems-based approach and differential diagnosis of chest pain in pediatric patients may lead to inappropriate use of electrocardiography and echocardiography. Clinicians should be aware of the various causes of chest pain in children and the current guidelines and algorithms being used to determine which children are at risk for cardiac chest pain and should have further testing performed.

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Chest pain is a common complaint in the pediatric population, encountered in both outpatient settings and emergency and urgent care settings. There are numerous causes of chest pain in children, with most studies ultimately not determining an etiology (1) or attributing the pain to musculoskeletal causes. The complaint may be anxiety provoking for patients, their families, and care providers alike because a cardiac cause is often feared (2)(3)(4); however, the...

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