Jul, 14
Dr. Nicolas Madsen

About the Author Dr. Nicolas Madsen

Nicolas Madsen, MD, is a cardiologist at Cincinnati Children’s Heart Institute, with special interest in the prevention of cardiovascular disease. He is focused on research and community outreach programs to find better ways to screen and educate children and adolescents regarding their risks for heart disease or sudden cardiac arrest.


  1. Informative article. Thank you. My 14 year old son has had chest pains for months. His pediatrician indicated maybe pleurisy. In addition, he feels that when he jumps something is loose and moving inside his chest and abdomen. He also has palpitations and last night I could hear it from a foot away (literally) – a sloshing and clicking sound. It was gone in a few minutes. He is sick with a flu like virus now, but this has been going on for months.

    Lisa - February 1, 2015 at 3:17 am Reply
  2. My 15 year old son just called me complaining of a sharp pain where he feels his heart hurts it is a pain he never felt before. It is a constant pain that has not gone away. He was sick a few weeks ago with a really bad cold and it seems as if he is getting sick again with the cold. His throat is soar and he is coughing too. Not sure what to do other than keeping a close eye on him and see if the pain continues, if it does than take him in to looked at. Pain in the chest just scream alarm but I am not sure. I hope someone can help!

    Veronica - February 4, 2015 at 5:03 pm Reply
  3. I have an 11 year old that has started complaining of chest pain for a little over 2 months. The pain comes and goes quickly lasting a minute or less. It also does not strike in the same spot usually above either breast bone.He has had it twice towards the center of left breast bone. It has always stricken during down time sitting in class or just at home. Last night it happened on our drive home after 50 minute karate class about 15 minutes into our drive. I am one of those worry some moms. He has been to the cardiologist and EKG was normal and so was his chest ultrasound (dont know if thats what its called). Our doctor gave us a monitor for 1 month to record episodes and out of the 5 we have so far everything looks normal. Im looking for some insight with your experience of what might be causing this. Or a suggestion of any further test. He is very active 95 pounds. No passing out or sweating no temperature during episodes. Heart rate high 90’s when it occurs. Thanks in advance.

    Marcie - February 6, 2015 at 10:59 am Reply
  4. My 14yo son has complained about chest pain while training for,and playing, basketball and on one occasion after a bike ride. Today during his game he had pain, his face was white and afterwards, though he felt better, his face was blotchy, very red around his eyes and still white in patches. He also on occasion has mentioned feeling dizzy. I am planning to take him to see our gp next week. Should I take him sooner?

    Michelle - February 6, 2015 at 10:01 pm Reply
  5. My son is 4 years old. He keeps complaining about his heart pain. It happens after eating his food and at times even before eating . Is it a chest burn or some thing else. I showed him to a pedestrian. The doc says it’s just chest burn. I am confused because it’s happening for past 5 to six months..

    Roshni - February 7, 2015 at 5:58 am Reply
  6. Hi,

    My 6 year old girl, is complaining that her “heart hurts”. She seems to be happy and active, but comes back every 40 mins complaining again.

    I dont want to just assume its muscular and it actually be something bigger.

    Please advise


    mirium - February 8, 2015 at 7:03 am Reply
  7. My daughter will be 8 in one week. She had a cold several weeks ago but got through it fairly quickly and since then occasionally complains of chest pain. It is often accompanied by stomach pain. When we’ve walked the family dog she does fine unless we go fast (very light jog), then complains of chest pain again. Today we went shopping with my mom, she had stomach pain that went away after using the restroom, and then she had a big lunch and within about 30 minutes was complaining of stomach, chest and jaw pain. I was taking her to urgent care but buy the time we got to the parking lot she said it was just her stomach, not her chest or jaw anymore so we left, and then later she said it hurt a little again. As of right now I plan to watch her very closely and try to get her in to see our pediatrician this week and go from there.

    Nicole - February 8, 2015 at 7:54 pm Reply
  8. My son is 6 and half average height and weight and normally very active. He has had no illnesses, not even any colds and is very healthy. He had be complaining of pain in his heart after exercise (running, karate ttrampolining etc) he says it feels like his heart is going to explode and he has to stop the activity to stop the pain
    He has been to his paedratucian who did an ecg which was normal and she also referred for a chest x Ray also normal. She has done a referral for a cardiologist but we can’t be seen for 5 weeks and I am worried as he is now complaining when just walking. I already took him to the ER has he had it happen at school playing tag and was in aginy so went to the school nurse. No one (dr or insurance) seems to be treating it urgently despite my numerous calls/visits expressing my concern. They way I see it a normally active ) year old is struggling during physical activity and this doesn’t seem normal to me!
    Thanks Sarah

    Sarah Gavaghan - February 9, 2015 at 10:16 pm Reply
  9. My daughter is 10 years old and she had ear infection first and doctor gave antibiotics. By taking antibiotics she got chest pain and again doctor gave high dose of pain killer still she has chest pain and heart pain from 2 weeks, her pediatric said its acidity and constipation and gave her constipation powder but pain is still same.
    Is the pain is because of acidity and constipation or she has something else problem.
    Iam really worried for her and can’t see her in pain.

    Janvi - February 10, 2015 at 1:46 am Reply
  10. My son is 11 and is a very stout young man.He is active and is able to lift and carry nearly 100 pounds as well as very broad shouldered and barrel chested. He has been complaining of right sided chest pain for a week or so. We’ve taken him to the chiropractor and had him adjusted and he has indicated chostochondritis. I’ve been giving ibuprofen and heat packs for the discomfort. It has not been activity based pain as it seems worse in the evening as he is quiet. The pain seems to be more intense today than it has been with making it difficult to get comfortable enough to sleep or even breath deeply. I do know that they have been doing intense exercise in their physical education class and question this being some of the issue. Wondering if chostochondritis vs. Pluresey or something else? Please help!!

    Roxanne Hevelone - February 10, 2015 at 4:03 am Reply
  11. My 14 year old grandaughter while playing on basketball team had 2 events occur at 2 games. While playing ,had to come out of game very pale , co squeezing in her chest and inability to breathe. Breaths were very shallow. She rested for a 15 min period went back into the game but lasted only seconds. Complained of heart hurting. Pain in chest center. 2 nd event even worse than first. No complaint prior to game or ever. Fine since. As stated she got very pale . SHe has appt. next week with dr. Should I be concerned. She is in my care.

    Gail - February 11, 2015 at 2:02 pm Reply
  12. My 14 yr old son has Addison’s Disease, and MEN, and araynauds. For the past two weeks he has been complaining of an “odd pressure” in his chest. I asked him if it felt like trapped gas (he’s had that before). He said “no. It feels like something is trying to come out of my chest, and I can’t breathe well.”
    He is permanently on lower levels of prednisone for his Addison’s, so his immune system is very weak, and he pretty much catches everything. Does this sound like something I should address with his pediatrician, or his endocrinologist, or both?

    Angela - February 21, 2015 at 8:41 pm Reply
  13. 10yr daughter, complains of having “kiddy heart attack” when she is in active play from dance game on Wii, to limbo at church. I heard this a couple times in last 6 months, but apparently had this in public school last year. She is homeschool now and is very tired about 1 hour after eating and needs a nap, complains of stomach aches almost daily at different times of day. She is not on any meds. Last week she chose not to do something for fear her chest would hurt. We have no insurance or pediatrician. She is up to date on shots, and has not had Streep throat since being out of school. (3 x a year in school). Could I just call a local pediatric cardiology office to save $$$ on a pediatrician visit, or should I find one. I understand the less than 1 percent heart issues. Husband thinks it will pass. But what about the 1 percent, are we stressing her heart. No stress now she is home very relax and happy. Home from.school since Aug 2014

    robyn addison - February 22, 2015 at 5:18 pm Reply
  14. Hello, my name is Filippa and I will be turning sixteen this year (born 1999). I have been experiencing a Very sharp pain in my chest both on the left and right side but its more common on the left side. Before having chest pains I didn’t do any activity, actually there’s been several times where I’ve woke up and then had chest pains, also when I go to bed while laying still. I haven’t been sick recently but I’ve had a headache for a long time. The chest pains come and go, sometimes months between. The chest pains have been going on since 2014. The pain definitely increased when I tried to sit up in my bed and if I would’ve rate it, it would have been a sharp 7-9/10. These chest pains only last for a couple of seconds sometimes longer then earlier, but I dont feel any tenderness around the area. I feel very uncomfortable with these chest pains and haven’t told my parents yet but I know my brother have experienced the same thing. I can never predict these chest pains or feel them coming. Also, I don’t feel any kind of stress, although I’m stressed very often. When I experience these chest pains it sometimes makes it hard to breathe and I don’t know what to do to stop them, I’ve tried not moving but that doesn’t work either and when I tried to sit up it hurt even more. In general I would say the pain often is severe.

    Filippa - February 23, 2015 at 4:19 am Reply
  15. My 14 year-old daughter has been complaining of a feeling of “pressure” right above her chest. It comes and goes and she rates the pain about a #5 on a pain scale of 1-10. She has UC and about 2 weeks ago she went off of her daily meds (Lialda) for good. She had this same symptom (chest pressure) when she was going off of prednisone but then it went away. Do you think it could just be growing pains? Or do you think it has something to do with her UC/going off her meds? She is in excellent health, otherwise. Her inflammation numbers (in her blood and stool) were just tested in December and they were great! Any advice would be really appreciated! Thanks a million Dr. Madsen…….so glad you went to med school:)lol!

    Jen - February 23, 2015 at 2:06 pm Reply
  16. Thank you for responding

    Robyn Addison - February 24, 2015 at 10:27 am Reply
  17. Hello! My son is 7 years olds and has had a fetal Echo and was checked out 2 times after birth and was cleared by the cardiologist. His 15 year old sister has HLHS so we were very cautious. He is currently on day 6 of amoxicillin for strep. At his appointment a new nurse practitioner mentioned he had a loud murmur which I was aware that he does have one. This morning he started complaining that his heart was hurting. I felt his chest and it seemed to be beating hard and fast. I counted 108 beats per minute. He then complained the right side of his chest hurt. After some time reassuring him that he was ok and distracting him, his heart rate went down to 92. Is there any delayed heart defects unseen during infancy or arrhythmia problems I should be concerned about? I have worried so much for my children that I don’t want to freak out.

    Beth - February 25, 2015 at 9:33 am Reply
  18. Hi, my brother is 13 years old with IBS and a bit overweight. He has a tendency to stress himself out over literally everything and get aggressive. He has been complaining about chest pains ( they occur in the middle of his chest 99% of the time) when he does get stressed and they tend to be really uncomfortable for him, his IBS also plays up when stressed which doesnt really help either. One night his pains were so severe that he was actually screaming and crying, however he had a bad cold at the time. We took him to the doctor several weeks ago and he checked his heart beat and such and said he didnt think anything bad of it.
    What I am asking is whether we should be concerned over these pains or are they harmless?

    J - February 25, 2015 at 2:02 pm Reply
  19. Hi, my name is Sam and I am 16 years old. I have been experiencing chest pains in the left side of my chest. Often they’re in different places buy this has been occurring for around 3 months now. I get the pains pretty much everyday throughout the day but most of the time I could ignore the pain but on the odd occasion the pain tends to be quite painful. I am seeing a doctor about it and they’ve said it’s probably not something to do with your heart. Thankyou.

    Sam - February 28, 2015 at 3:03 am Reply
  20. My 11 year old daughter complains of sudden chest pain while doing strenuous activities. This has gone on off/on for 6 months. When we visited her doctor, he called the condition Costochondritis. Read upon it, but still months later she still has pain when doing anything strenuous. I’m concerned about this being something that was missed as an infant. I was told she had a heart murmur at birth, but that it would close. What are your thought on this issue. A child just had a heart attack at her school while playing soccer, and was later said to have had anomalous let coronary artery. I just don’t want to see the same for my child.

    arlana odden - March 2, 2015 at 2:27 pm Reply
  21. Hello, Sam again, I recently had an ECG (3 weeks ago) and the results came back. My doctor says everything looks fine but there was something unusual in the pattern that shows and suggests that my left side of my heart could be bigger than my right side. She still thinks it’s nothing to do with my heart but is asking a cardiologist for further advice. Should there be anything to worry about? Because what if that is the reason I am getting pains?

    Sam - March 3, 2015 at 12:56 pm Reply
  22. Hi Dr. Madsen. I appreciate this blog and the 6 questions to ask my child about his chest pain – thank you for this information. My 7 year old son is complaining of chest pain (in the center of his chest)for 3 days now. Overnight it has caused him to wake up twice and this last time it is consistent pain. No fever, recently did have a cold and ear infection. He is overweight and in my mind I downplay it because as you state most chest pain is not heart related. However, this consistent pain and his visible discomfort has me concerned now. Am I justified in this concern and should I take him to the pediatrician or assume this will pass? The pain is there with or without exertion and he has told me he doesn’t want to laugh or play because it makes it harder for him to breath…. Thank you! A concerned mother.

    Emily - March 7, 2015 at 7:05 am Reply
  23. Hi, My daughter is 8 1/2 and we have recently started running. The last 3 days, we’ve walked 4 minutes and run 1 minute. Each time we’ve run in these 3 days, in less than a minute she stops and complains her chest stings as she points to the middle of her Sternum. So we end up just walking. Last night I could see it in her face it didn’t feel well. I asked if she could breath okay and she said yes. I asked if it hurt any other time and she said when she is in gym. Any ideas?

    Megan - March 10, 2015 at 9:13 am Reply
  24. My 15 year old son for months now has been getting a sharp pain in the center of his chest.He could just be sitting or walking through the house & out of no where comes the sharp pain in his chest.Mostly center that makes him grab it & kneel over.It lasts for seconds to 5 minutes at a time.Hes average active & otherwise healthy.He says it doesn’t hurt to breathe in but I’m making him an appointment tomorrow morning since he just had another episode.About 1-2 a day.Also he wakes up during the night with severe Charlie horse pains in his legs.The Dr recommended Gatorade & bananas for that.Could this be connected?

    Concerned mom - March 11, 2015 at 1:18 am Reply
  25. I am a 15 year old girl, i often have hert and lung pain but im not sure why its just at random times not after food or sitting or anything. I am really worried what it could be. Please help.

    Erin - March 12, 2015 at 2:19 pm Reply
  26. I have 11 years old daughter. She began to cough in November 2014, it is 4 months now. We saw asthma specialist, lung specialist, pediatrician, children hospital…. She got coug syrups, antibiotics, steroids, inhalers.”…she still cough. She has mild scoliosis at her chest area. We see chiropractor, but she also complains of sharp poking pain on left side under breast, and can’t breath out. Poking is also sudden, last few seconds.sometimes it moves to right side. I am so worried, and desperate for an answer. Not sure doctors know what is going on. She also has low level of vitamin D, she started suplement. Question is why coughing deep, dry, Barky cough for 4 months,no medicine helped, and why sharp poking pain.? Any advice will be appreciated. We are taking her to children’s lung specialist in a week.

    Alena - March 14, 2015 at 10:20 pm Reply
  27. I have an 11 year old daughter that has been complaining of sternum pain for several months. She describes the pain as dull, sore, and pressure-like. The pain is on each side of the sternum and very tender to the touch. It is pretty much always present, however, she notices it more while not active. She is in many school sports and never complains upon activity. She actually gets relief from this pressure when taking a deep breath. She has had an x-ray which was clear. Her pediatrician has referred her to physical therapy and she had evaluation today. PT said he did not know but prescribed a few exercises since it appears to be related to musculoskeletal pain. She had full cardiac work up approximately 1 1/2 years ago as her brother was diagnosed with Kawasaki Disease and we wanted to be sure we did not miss it in her when she was younger. Any suggestions or insight would be greatly appreciated. Having one child with acquired heart disease has made me much more vigilant to possible rare conditions. Thank You for your time.

    Toni - March 16, 2015 at 8:47 pm Reply
  28. Hi, my son is 17 and he has been very active and participated in many sports. About 8 months ago he started having problems with chest pains on the left side during exercise. He can only exercise for about 8 minutes and then he gets chest pains, shortness of breath, light headed, and his left shoulder and neck hurt. We have seen the doctor and have done a stress test. The doctor said his pulse and blood pressure or something like that reached really dangerous levels, but they couldn’t figure out why. Could this be related to the heart at all? Thanks

    Amy - March 17, 2015 at 10:47 pm Reply
  29. Hello Dr. Madsen,
    I happened to come across your site while researching information about my 14 year old daughter’s ongoing concerns. She has been experiencing moderate pain in her central and left sternum for months as well as a fluttering and vibrating sensation to the left of sternum. Has also complained of a “skipped beat” sensation over the years. She is very active in both soccer and track and has recently increased her amount of running which seems to have aggravated the situation further. She does not have an increase in pain, nor is she short of breath or dizzy, during exercise. Initial diagnosis was costochondritis which did not resolve after 2 weeks of motrin/rest. Her pedatrician would like her to return to see her but my thought is that it may be time to visit a cardiologist. Would appreciate your thoughts/feedback. Thank you! Kelly

    Kelly KeRonne - March 18, 2015 at 2:22 pm Reply
  30. My child is 6 years old and for the last 2 days she said that her chest hurts when she is running in the playground. She then stops running and then she feels better.
    Any Ideas?

    G - March 20, 2015 at 12:30 pm Reply
  31. Hello, the doctor got back to me and the cardiologist suggested no further action and they aren’t worried about me because of my age (16) but when I get the chest pains sometimes I get aches in my left arm or near to top left side of my chest. After I had my ECG scan the doctor said I had a small LVH and I’ve searched this up on the Internet and it looks worrying but I keep getting the pains and I’ve got a another appointment soon so should I see the cardiologist just to make sure because in some cases this pain I am getting makes me feel like it’s a heart pain and I’m scared about it. Thankyou for reading.

    Sam - March 21, 2015 at 6:15 am Reply
  32. Hello,

    I am 19 years old and have been experiencing chest pains for 11 months. The pain occurs on the left side, just inside, and below my nipple. The pain is consistently dull and occurs at any time at random(sitting or walking around).
    ***It usually lasts from anywhere from 20 mins to a couple hours to all day. This also happens every day.

    I read online, and see that there are many pains associated with heart related issues. Here are mine that seem to be related to a heart issue.
    -pain in the left forearm (thumb side)
    -pain in left shoulder
    -pain in left neck
    -pain in upper back

    ***The upper back pain is inside the left shoulder blade usually occurs 10 minutes into a run and it aches. It also occurs randomly throughout the day

    ***The left forearm pain is more of a *zing* or *shock* sensation and doesn’t last longer than 2-4 during exercise, and is consistent with happening after about 8 miles into a run.

    ***Left shoulder pain comes at random throughout the day but not every day

    Exertion does not seem to make the chest pain noticeably worse, but I can feel that it is definitely there. I have never passed out or experienced shortness of breath.

    Also, I get this left side twitch in my neck, and I was wondering if that could have anything to do with my artery fluttering?

    I went to the doctor and scheduled a stress test. It came back normal, except there was a possible Left Ventricular Hypertrophy. I am a marathon runner and hearing that makes me nervous. (last intense run i have done was December 15th, 11mi run, but have cut down because I am nervous) I haven’t had the chance to talk to my GP yet about the test because she is out of town until April 15th.

    My mother had SVT(fixed with abrasion, and i never get a heart rate over 175 or experience her symptoms) and grandpa had a heart attack at 48, and survived until he was 80. Other than that no other heart issues in my family.

    Sorry for the long post, just need an opinion. Thank you!

    Craig - March 21, 2015 at 5:06 pm Reply
  33. HI! My son is 5. He has been complaining with his chest hurting for at least 6 months now. It started when he was 4. He will stop whatever it is that he is doing at the time and grab his chest. He always has this really sad, almost scared look on his face. Most of the time he tells me that the pain is in the center of his chest, sometimes its either to the left or right side. Most episodes happen while he is eating, however it has also happened several times while resting, playing etc. It happens at school, home, in the car, anywhere. It has even woke him up from sleeping before. I have been keeping records of his complaints. This happens very frequently. By frequently, I mean that out of the last 28 days, he has complained of this 34 different times. He sometimes tells me that “it feels like a fish flouncing around in my chest”. “a stick poking me” and just a couple of weeks ago he was eating, and suddenly stopped, grabbed his chest, looked at me and said “I wish someone could cut my chest open and make it stop hurting”. Guess you can imagine how that made me feel!!! I was diagnosed with WPW when I was younger and had to have cardiac ablation done on both sides of my heart, I was told by my cardiologist that my problem was most likely there since birth and only worsened as stress became a part of my life. I was also told that WPW was hereditary. There is a pretty significant history of heart issues in our family. This made me even more concerned. I took my son to his pediatrician, who done an ekg (normal), but so were all of my ekgs. The only way they caught mine was thru me wearing a heart monitor. His doctor told me to simply watch him. A few months passed and he still complained of these chest pains, so I took him back. The dr then informed me that he thinks it is acid reflux, started him on Zantac and referred us to a peds gastro specialist. My son was seen there mid feb. this year, they started him on Prilosec and continued the zantac. Nothing has changed, like I said out of the past 28 days he has complained 34 times. Most recent complaint was this morning at school, his teacher told me that they were standing up singing, when again he stopped and grabbed his chest. He told her his chest was hurting. She also told me that she noticed something different this time. She said he turned really red and looked like he was going to pop out in a sweat. Also he has had a dry, nagging cough off/on for probably 3 to 4 months now. It’s not a hard full force cough like when he is sick, it seems to happen most often when he is running (short distances). He does not always complain of chest pain at the same time of this cough. I have been made feel like I am crazy and that his doctor is tired of seeing him. I fully understand that this could be nothing that will truly harm him, however as a mother I do worry and I want to know what is causing this, I want the doctor to listen to my concerns and not diagnose my son before the he even enters the room. Any suggestions would be appreciated. Thank you

    One Very Frustrated Mom - March 23, 2015 at 4:04 pm Reply
  34. Thank you! I agree with you and would certainly feel better about the whole situation if the doctors would do this, even if it showed nothing.

    one very frustrated mom - March 24, 2015 at 10:05 pm Reply

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