CHEST PAIN IN CHILDREN

Introduction Gastrooesophageal reflux disease (GERD) could be one of the causes of chest pain with or without Helicobacter pylori (HP) infection. Aim To evaluate origin of chest pain and to correlate positive history of chest pain and gastrointestinal system diseases. Subjects and Methods During 01.01.2005. to 01.01.2008., 352 patients age 4 to 18 years, from Cardiology and Gastroenterology department of Paediatric clinic of CCU Sarajevo with history of chest pain were investigated. The evaluation was done by protocol: history, physical examination, ELISE test on HP, oesophagogastroduodenoscopy (EGDS) with biopsy and histological examination, Holter ECG, echocardiography, psychogenic assessment and laboratory parameters. Results From 352 investigated patients with chest pain, 80 (22.7%) were ELISE HP and EGDS biopsy positive, 64% pts were females. Patients were divided in groups: I: age 4–11 years (with in 21.2% positive findings), II: age 11–15 years (HP+ in 56.2%), and group III age 15–18 years with in 22.6% positive HP findings. Laboratory parameters were normal. Psychogenic findings were positive in 12.5% pts. By ECG Holter in 3.6% a premature extrasystole were detected. Patients with HP infection were treated according therapeutic protocol with proton pump inhibitors plus two antibiotics for 4 weeks. During follow up post therapy period of six months, there were no subjective or clinical signs of chest pain in 52.5% patients. Conclusion The cause of chest pain in this study, in presence of HP infection was detected in statistically significantly higher percentage in older groups of patients. With appropriate therapeutic treatment, chest pain symptoms were solved.