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Forum Name: Cardiology Symptoms

Question: Teenager With Exercise Induced Chest Pain


 Kay - Thu Apr 22, 2004 2:26 pm

My 14 year old daughter has these episodes when she runs or when she has been hit or something (more emotionally triggered) during practice.

When these occur she says her chest hurts like it is being squeezed, sweaty, pale, lethargic, fairly unresponsive (to your voice), her eyes roll as if she is about to pass out. These pass in about 5 to 10 minutes when she is back to being more responsive, etc. At one time she passed out trying to run around the school during practice. The PCP said it was probably exercise induced asthma and from the beginning had given her an inhaler to use before activity and during an episode. While at a competition she had a really bad episode after she and a few team mates fell trying to catch a girl during competition, chest began to hurt finally full blown episode, chest pain, extremely pale and sweaty, eyes when back and she was unresponsive, half way carrying her outside the paramedics caught us and began to check her out after a few minutes they checked her breathing because we discussed asthma they said her breathing sounded great, but more concerned that she had been unresponsive and her heart was beating way to fast. After about 5 more minutes she was responsive again and heart was slowing down. As usually she's much better just fatigued after these maybe acts a little confused for abit. The PCP now does think she has asthma but doesn't think any needs to be addressed anymore because it's probably muscoskeletal. The school and the cheer gym still refuse to run her because they feel it's not right and want no responsibility, they just have her walk or do stationary bike.

FYI... She is also being treated by the PCP and the Pediatric Orthopedic for wrist pain in both wrist.. tenditis. We have been battling this for about 8 months, we take 4 to 8 weeks off from tumbling or cheer, did physical therapy, and some days still have swelling and pain. She returns to cheer and tumbling and we end back up at the beginning. At one point we had both wrist, knees, and ankles with pain and swelling while we were not cheering or tumbling. We now are down to the wrist again. She has had a low grade fever (99 - 100) for 6 to 8 months also and seems increasingly fatigued and just a general feeling of not feeling well.

She had blood work tested for arthritis and lupus and both came back OK. MRI on left wrist showed tenditis but no joint damage.

I know this is a lot of information, but I tried to give an overall discription just encase it could all be related.

Any guidance at this point would be greatly appreciated about the chest pain.
 Dr. Yasser Mokhtar - Thu Apr 22, 2004 4:31 pm

User avatar Dear Kay,

Even though your description is not typical to that of the sudden syncope (loss of consciousness) that happens to people who have hypertrophic cardiomyopathy when they exercise, i would strongly urge you to have your daughter checked for this condition by doing an echocardiogram (ultrasound of the heart).

If you want to know whether your daughter has asthma or not, there is a test called the methacholine challenge test which can have to see whether she has asthma.

Regarding the fast heart rate that your daughter was told to be experiencing while she is not responsive, i would suugest to have a Holter Monitor (24 hours heart monitor) and let her exercise and see what kind of fast rhythm does she go into.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.

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