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Investigation of the presence of atopy in children visiting the paediatric cardiology department due to chest pain

Published online by Cambridge University Press:  19 July 2023

Fatma Duksal Open the ORCID record for Fatma Duksal [Opens in a new window]  and
Melih Timuçin Doğan Open the ORCID record for Melih Timuçin Doğan [Opens in a new window]
Fatma Duksal*
Affiliation:
Konya City Hospital, Konya, Turkey
Melih Timuçin Doğan
Affiliation:
Konya City Hospital, Konya, Turkey
*
Corresponding author: F. Duksal; Email: fatmaduksal@gmail.com
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Abstract

Background:

The cases of chest pain in children are usually not of cardiac origin.

Objectives:

To investigate asthma and other atopic diseases in children with chest pain not of cardiac origin.

Patients and Methods:

Children aged 6–18 years who were seen for chest pain were included in the study. Haematologic parameters, pulmonary function tests, and skin prick tests were performed. Atopic diseases and environmental factors were investigated.

Results:

The non-cardiac chest pain group (Group 1) included 88 children (female: 53.4%) with a mean age of 11.9 ± 3.4 years; the control group (Group 2) included 29 children (female: 53.8%) with a mean age of 11.4±2 years (p > 0.05). A family history of atopy (22.7%) and skin prick test positivity (28.4%) was more common in Group 1 than Group 2 (p = 0.006 and p = 0.017, respectively). The rate of presence of all environmental factors except stove use and mould was significantly higher in Group 1 (54.5%) than Group 2 (3.4%) (p < 0.001). Asthma was diagnosed in 44.3% and allergic rhinitis in 9.1% of patients in Group 1. Idiopathic chest pain, musculoskeletal system disorders, gastroesophageal reflux, and pneumonia were identified in 23.9%, 11.4%, 8%, and 3.4% of patients in Group 1, respectively.

Conclusions:

In this study, the most common cause of non-cardiac chest pain was asthma. The local prevalence of asthma is higher than normal, and this may have affected the results of this study. A detailed history and physical examination will accurately establish the cause of chest pain in most children.

Keywords

Asthmaatopychest pain
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 3 , March 2024 , pp. 489 - 496
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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References

Hussain, MZ, Ishrat, S, Salehuddin, M, Mahmood, M, Islam, MT. Chest pain in children: an update. Mymensingh Med J 2011; 20: 165–170.Google Scholar
Kenar, A, Örün, UA, Yoldaş, T, Kayalı, Ş., Bodur, Ş., 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.Google Scholar
Dimache, M, Turcan, E, Nătase, M. Noncardiac chest pain and gastroesophageal reflux disease. Rev Med Chir Soc Med Nat Iasi 2010; 114: 342–348.Google Scholar
Sert, A, Aypar, E, Odabas, D, Gokcen, C. Clinical characteristics and causes of chest pain in 380 children referred to a paediatric cardiology unit. Cardiol Young 2013; 23: 361–367. DOI: 10.1017/S1047951112000881.Google Scholar
Drossner, DM, Hirsh, DA, Sturm, JJ, et al. Cardiac disease in pediatric patients presenting to a pediatric ED with chest pain. Am J Emerg Med 2011; 29: 632–638. DOI: 10.1016/j.ajem.2010.01.011.Google Scholar
Edmondstone, WM. Chest pain and non-respiratory symptoms in acute asthma. Postgrad Med J 2000; 76: 413–414. DOI: 10.1136/pmj.76.897.413.Google Scholar
Browne, LR, Gorelick, MH. Asthma and pneumonia. Pediatr Clin North Am 2010; 57: 1347–1356. DOI: 10.1016/j.pcl.2010.09.002.Google Scholar
Global Initiuative for Asthma. Global strategy for asthma management and prevention: revised asthma guidelines 2020 [Internet], 2020, https://ginasthma.org/wp-content/uploads/2020/04/GINA-2020-full-report_-final-_wms.pdf, Accessed October 20, 2020,Google Scholar
Network, Global Asthma. The Global Asthma Report 2014. Global Asthma Network, Auckland, New Zealand, 2014.Google Scholar
Brito, FF, Mur, P, Barber, D, et al. Occupational rhinoconjunctivitis and asthma in a wool worker caused by Dermestidae spp. Allergy 2002; 57: 1191–1194. DOI: 10.1034/j.1398-9995.2002.23676.x.Google Scholar
Thorne, PS, Kulhánková, K, Yin, M, Cohn, R, Arbes, SJ Jr, Zeldin, DC. Endotoxin exposure is a risk factor for asthma: the national survey of endotoxin in United States housing. Am J Respir Crit Care Med 2005; 172: 1371–1377. DOI: 10.1164/rccm.200505-758OC.Google Scholar
Sancakli, O, Tuncel, T, Eren Akarcan, S, Kanık, A, Özyurt, G, Ozdogru, EE. Anxiety levels and changes in health and hygiene behaviors in mothers of children with asthma in early COVID-19 lockdown in Turkey. Pediatr Allergy Immunol Pulmonol 2022; 35: 27–35. DOI: 10.1089/ped.2021.0113.Google Scholar
Aaron, SD, Boulet, LP, Reddel, HK, Gershon, AS. Underdiagnosis and overdiagnosis of asthma. Am J Respir Crit Care Med 2018; 198: 1012–1020.Google Scholar
Liu, AH, Zeiger, R, Sorkness, C, et al. Development and cross-sectional validation of the childhood asthma control test. J Allergy Clin Immunol 2007; 119: 817–825. DOI: 10.1016/j.jaci.2006.12.662.Google Scholar
Lin, CH, Lin, WC, Ho, YJ, Chang, JS. Children with chest pain visiting the emergency department. Pediatr Neonatol 2008; 49: 26–29. DOI: 10.1016/S1875-9572(08)60007-8.Google Scholar
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.Google Scholar
Selbst, SM. Approach to the child with chest pain. Pediatr Clin North Am 2010; 57: 1221–1234. DOI: 10.1016/j.pcl.2010.09.003.Google Scholar
Selbst, SM, Ruddy, RM, Clark, BJ, Henretig, FM, Santulli, T Jr. Pediatric chest pain: a prospective study. Pediatrics 1988; 82: 319–323.Google Scholar
Evangelista, JA, 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.Google Scholar
Asher, MI, García-Marcos, L, Pearce, NE, Strachan, DP. Trends in worldwide asthma prevalence M. Eur Respir J 2020; 56: 2002094. DOI: 10.1183/13993003.02094-2020.Google Scholar
Song, P, Adeloye, D, Salim, H, et al. Global, regional, and national prevalence of asthma in 2019: a systematic analysis and modelling study. J Glob Health 2022; 12: 04052. DOI: 10.7189/jogh.12.04052.Google Scholar
Asher, MI, Rutter, CE, Bissell, K, Global Asthma Network Phase I Study Group, et al. Worldwide trends in the burden of asthma symptoms in school-aged children: global asthma network phase I cross-sectional study. Lancet 2021; 398: 1569–1580. DOI: 10.1016/S0140-6736(21)01450-1.Google Scholar
Weiland, SK, Björkstén, B, Brunekreef, B, et al. Phase II of the international study of asthma and allergies in childhood (ISAAC II): rationale and methods. Eur Respir J 2004; 24: 406–412.Google Scholar
Silverwood, RJ, Rutter, CE, Mitchell, EA, et al. Are environmental risk factors for current wheeze in the international study of asthma and allergies in childhood (ISAAC) phase three due to reverse causation? Clin Exp Allergy 2019; 49: 430–441.Google Scholar
Civelek, E, Cakir, B, Boz, AB, et al. Extent and burden of allergic diseases in elementary schoolchildren: a national multicenter study. J Investig Allergol Clin Immunol 2010; 20: 280–288.Google Scholar
Duksal, F, Becerir, T, Ergin, A, Akcay, A, Guler, N. The prevalence of asthma diagnosis and symptoms is still increasing in early adolescents in Turkey. Allergol Int 2014; 63: 189–197. DOI: 10.2332/allergolint.13-OA-0612.Google Scholar
Baççıoğlu, A, Söğüt, A, Kılıç, Ö., Beyhun, E. The prevalence of allergic diseases and associated risk factors in school-age children and adults in Erzurum. Turkey Turk Thorac J 2015; 16: 68–72. DOI: 10.5152/ttd.2015.4229.Google Scholar
Saraçlar, Y, Kuyucu, S, Tuncer, A, Sekerel, B, Saçkesen, C, Kocabaş, C. Prevalence of asthmatic phenotypes and bronchial hyperresponsiveness in turkish schoolchildren: an international study of asthma and allergies in childhood (ISAAC) phase 2 study. Ann Allergy Asthma Immunol 2003; 91: 477–484.Google Scholar
Ones, U, Akcay, A, Tamay, Z, Guler, N, Zencir, M. Rising trend of asthma prevalence among Turkish schoolchildren (ISAAC phases I and III). Allergy 2006; 61: 1448–1453. DOI: 10.1111/j.1398-9995.2006.01145.x.Google Scholar
Guner, SN, Gokturk, B, Kilic, M, Ozkiraz, S. The prevalences of allergic diseases in rural and urban areas are similar. Allergol Immunopathol (Madr) 2011; 39: 140–144. DOI: 10.1016/j.aller.2010.05.004.Google Scholar
Yazar, B, Meydanlioglu, A. The prevalence and associated factors of asthma, allergic rhinitis, and eczema in Turkish children and adolescents. Pediatr Pulmonol 2022; 57: 2491–2501. DOI: 10.1002/ppul.26065.Google Scholar
Oncel, H, Meshur, MC. Urban sprawl and its reasons in the growth process of Konya urban area. Planning 2021; 31: 191–207. DOI: 10.14744/planlama.2021.04127.Google Scholar
Bercedo Sanz, A, Martínez-Torres, A, González Díaz, C, Grupo GAN España, et al. Prevalence and temporal evolution of asthma symptoms in Spain. Global asthma network (GAN) study. An Pediatr (Engl Ed) 2022; 97: 161–171. DOI: 10.1016/j.anpede.2021.10.005.Google Scholar
de Oliveira, TB, Moscon, JG, Ferreira, ENDN, da Veiga, ABG. Prevalence of symptoms of asthma and allergic rhinitis in children in Southern Brazil: aten-year monitoring study. J Asthma 2020; 57: 373–380. DOI: 10.1080/02770903.2019.1573253.Google Scholar
Guilbert, T, Zeiger, RS, Haselkorn, T, et al. Racial disparities in asthma-related health outcomes in children with severe/Difficult-to-treat asthma. J Allergy Clin Immunol Pract 2019; 7: 568–577. DOI:10.1016/j.jaip.2018.07.050.Google Scholar
Asher, I, Ellwood, P, Gilchrist, C, et al. The Global Asthma Report 2018. Auckland. The Global Asthma Network, New Zealand, 2018.Google Scholar
Sekerel, BE, Soyer, OU, Keskin, O, et al. The reliability and validity of Turkish version of childhood asthma control test. Qual Life Res 2012; 21: 685–690. DOI: 10.1007/s11136-011-9970-z.Google Scholar
Zhang, YG, Huang, J, Zhang, J, et al. RANTES gene polymorphisms and asthma risk: a meta-analysis. Arch Med Res 2010; 41: 50–58. DOI: 10.1016/j.arcmed.2010.01.002.Google Scholar
Massin, MM, Bourguignont, A, Coremans, C, Comté, L, Lepage, P, Gérard, P. Chest pain in pediatric patients presenting to an emergency department or to a cardiac clinic. Clin Pediatr (Phila) 2004; 43: 231–238. DOI: 10.1177/000992280404300304.Google Scholar
Expert Panel Report 3 (EPR-3). Guidelines for the diagnosis and management of asthma-summary report 2007. J Allergy Clin Immunol 2007; 120: S94–138. DOI: 10.1016/j.jaci.2007.09.043.Google Scholar
Taniguchi, H, Kanbara, K, Hoshino, K, Izumi, S. Chest pain relieved with a bronchodilator or other asthma drugs. Allergol Int 2009; 58: 421–427. DOI: 10.2332/allergolint.08-OA-0084.Google Scholar
Chang, C. Asthma in children and adolescents: a comprehensive approach to diagnosis and management. Clin Rev Allergy Immunol 2012; 43: 98–137. DOI: 10.1007/s12016-011-8261-3.Google Scholar
Polk, S, Sunyer, J, Muñoz-Ortiz, L, et al. A prospective study of Fel d1 and Der p1 exposure in infancy and childhood wheezing. Am J Respir Crit Care Med 2004; 170: 273–278. DOI: 10.1164/rccm.200310-1348OC.Google Scholar
Gough, H, Grabenhenrich, L, Reich, A, MAS study group, et al. Allergic multimorbidity of asthma, rhinitis and eczema over 20 years in the German birth cohort MAS. Pediatr Allergy Immunol 2015; 26: 431–437. DOI: 10.1111/pai.12410.Google Scholar
Strina, A, Barreto, ML, Cooper, PJ, Rodrigues, LC. Risk factors for non-atopic asthma/wheeze in children and adolescents: a systematic review. Emerg Themes Epidemiol 2014; 11: 5. DOI: 10.1186/1742-7622-11-5.Google Scholar