American Board of Family Medicine (ABFM) Practice Exam

What is the most common source of chest pain among children?

1. Cardiac

2. Musculoskeletal

3. Pulmonary

4. Gastroesophageal

The correct answer is: Musculoskeletal

Musculoskeletal pain is recognized as the most common source of chest pain among children. In children and adolescents, chest pain is frequently due to conditions related to the chest wall, such as costochondritis or muscle strain, rather than cardiac issues. The growing musculoskeletal system, combined with high levels of physical activity, can lead to injuries and inflammation that manifest as pain in the chest area. Although various causes of chest pain exist, such as cardiac or pulmonary conditions, these are less common in the pediatric population. Cardiac ailments are notably rarer in children and often involve specific risk factors or underlying congenital issues. Similarly, pulmonary causes, such as pneumonia or asthma, can lead to chest discomfort but also occur less frequently than musculoskeletal problems. Gastroesophageal issues, including reflux or esophagitis, can be involved in chest pain as well but typically do not dominate the landscape of chest pain complaints in young individuals. Hence, due to the frequency of musculoskeletal injuries and conditions among children, this option stands out as the most prevalent source of chest pain in this age group.