DD 14, pains in chest

[lostinteaching47]

Hi, my eldest, 14 yr old DD is complaining of pains in her chest.I took her to the A&E the other month as she was crying she said it hurt so much.We were up there about 6 hrs in total and she was seen by 4 different Drs.They took a urine sample(fine) did examination(fine) temp was fine.They did an ECG and some other test all came back fine.She is saying it feels like a heaviness in her chest it's not her heart it's in her chest area but she obviously feels it's her heart and I guess it still could be? She was getting palpitations and was feeling sweaty.One Dr said it could be caffeine causing the palpitations so we cut out the coffee (1 weak cup in the morning on getting up, she doesn't touch fizzy drinks) and the palpitations have stopped.

The Drs (well, 2 of them) seem to think it is anxiety/stress related) and I think it is also. One of the Drs thought it could be dietary, like an acid reflux type thing? She is very slim, active, a fast runner, quite good at athletes but she is pale, one of her nicknames used to be Casper. She doesn't eat a fantastic diet so I guess it could be that.Sometimes she skips meals, I don't think she is concerned about her weight but she does have a friend who has just been diagnosed with an eating disorder and is being treated for depression.

At the hospital, we came away none the wiser really, they just gave us a letter for our GP to go and see him if we felt it was not getting any better to be wired up for a day and get a complete days reading of her heartbeat to see if there were any irregularities.I think we will have to go back and get this done in the 1st instance but I was just coming on here to see if anyone has had anything similiar with their children round about this age and what it was.

I'm scared if I'm honest of what it could be and I know I should take her it's just that I know that she will give the Dr wooly answers just like she did at the hospital which won't help but she really does find it hard to describe.She had it at the hospital, this pain when she was talking to the Drs and they were asking her to score it out of 10 and she was saying about a 6 or 7 and they were taking her pulse and temp and looking at her well, like they didn't believe her.
She is doing really well at school she is on track to get all A*'s .She puts a lot of pressure on herself, she wants to do well, for herself, she is finally seeing the importance of education.She had an awful yr 7 and most of yr 8, she got in with the wrong group of girls, her behaviour went off the rails, she was excluded for a week, she was being bullied , she was forever on some kind of report or other, I was always up the school.It was a very stressfull time for us all.Now she has been able to distance herself from most of that, being in the top sets has given her that freedom.It's a pretty rough school.
Her Science teacher pretty much washed his hands off her in Yr 7 after she did so badly, now he can't sing her praises highly enough.We are just so proud of her because she has got to where she is through persistance and sheer hard work.She has a mum and dad at home and a younger brother.She has friends, she is not being bullied(I think) She does go on Tumblr and that Ask? is it site.She used to go on FB a lot and get into all kinds of arguments on there but she has matured a lot.I went back to work last Sept, full-time.I'm a teacher so work long hours.I am wracked with guilt that I am not there in the mornings when she leaves for school or after school.
She says she has felt like this since about January but she can't be more specific, she can't think of anything which might have triggered it.She thinks she has GAD, she googles things a lot.I don't know, I think it could be anxiety.She says she's fine when she's busy, but she says she can't read anymore or watch a film her chest starts hurting too much.I will take her to the Drs this week(I can't ever get to phone or make an appointment because of my teaching and I can't take time out)

I'm sorry this is so long, does anyone have any experience of this?

TIA x

[lostinteaching47]

Just wanted to add, I have been asking her how's she been sleeping, how her chest has been but she has been playing it down and I wasn't worried as I thought she was o.k.Then yesterday she tells me it has been hurting as much as it was and she didn't tell me as I have been so pre-occupied with work.I have been under a lot of scrutiny being a returning teacher and I have had observations carried out on me and mentoring etc and I am just finding my class/teaching difficult.I work pretty much most evenings and if I'm not working or doing house chores I'm sleeping so I guess she's feeling pretty neglected which is making me feel awful.

[AGiddyKipperInOneHand]

Hi. Firstly, go to gp and get the 24 hour monitor. Do it on a stressy school day, not or the type of day she is in most pain. The hospital could have missed something, it is poasible. Your job as a parent is to seek professional medical help for your daughter. Her job is to tell you if she needs help (which she has) and it's the medics job to make sense of what she says and the readings.

I don't have any similar experiences with dcs, other than the guilt after returning to work. The older one occasionally says she has some chest pain, but nothing that lasts for more than a day or so.

I do know people with very serious heart conditions which were missed when they were growing up. It does happen. Don't feel like you are being a nagging parent by seeking help over something which is potentially very serious. If, say your daughter has a hole in the heart that has been missed until now, it could make the world off difference to her to get it dealt woth, rather than left undetected and become potentially life threatening in adult life. Whatever your employers think or say, your first duty is to your own child. You may have to take time off work to take your dd to appointments to get to the bottom of this, but if you explain it is a suspected heart defect then they will understand. They will probably realise that sorting this out and putting your child first will make you a better teacher, and less stressed.

I have had chest pain myself which I thought was my heart, it was a pulled muscle from when i was trying to paint a ceiling and lost my balance. I've had heartburn too, which can feel like it is heart related. (I needed to eat sitting up at a table and settle after a meal, and not have a hot drink with my. food.)

[MousyMouse]

asthma?
I sometimes get chest pains when breathing is bad. as I don't wheeze (just sigh and cough) it took ages to connect the chest pains with asthma.

[lostinteaching47]

Thank you for replying so promptly, AGiddyKipper(love the name).Yes, I can see what you are saying is right.I will find the time tomorrow morning to phone the Drs for an evening appointment (fingers x) I think this week will be very stressy for her as she has tests.I don't have any midmorning breaks and we are not meant to get/have our phones out in work but I will just have to tell my manager that I have to phone the Drs.I am obliged to stay in work until a certain time most of the week (contracted hrs?) but if I need to leave, I need to leave, I feel bad my daughter has been suffering with this and I didn't realise.i thought it was just occasional, not everyday.

[lostinteaching47]

MouseyMouse, yes, asthma was mentioned at the hospital when the 1st Dr was examining her but i don't think it is that, but then again you shouldn't rule it out.

[OhYouBadBadKitten]

Is reflux a possibility?
Did she have an echo at the hospital?

[lostinteaching47]

OhYou Bad, no, she didn't have an echo.

[lostinteaching47]

2fedup, I am trying to help her relax and get proper sleep, I think they call it sleep hygiene.She finds it difficult to actually fall asleep with her chest hurting.

[OhYouBadBadKitten]

That's a shame lostin, I'd ask for one, simple non invasive test.

[lostinteaching47]

She had an ECG, SVT, glucose blood prick, urine sample tested and obviously blood oxygen levels taken and lots of listening to her chest, back and about 2 different examinations of abdomen.No x-rays or scans or anything else.

[lostinteaching47]

Sorry, Ohyoubad, that's what an ECG is D'OH!!!! Yes, she did have one of those, was normal.

[Selks]

You said she thinks she has GAD... What other anxiety symptoms is she experiencing? (she may still have physical chest probs as well as anxiety but if she has anxiety then she'll benefit from help for that).
Has the GP weighed her and is she within normal range?

[lostinteaching47]

No, she hasn't been weighed.She tends to worry, finds it difficult to sleep without listening to music, having her sleep mask.She lost a lot of confidence after the bullying last year.She has concerns about not being pretty enough, being too spotty, not liking how she looks, never having the boys she likes like her.Having boys she just sees as mates like her(she finds this very stressful) She gets wound up by being let down by friends, she is very loyal.She has a lot of friends confide in her as she can keep a secret, from other girls but sometimes tells me.She has friends who self-harm and have suicidal thoughts and she finds this stressful.Also a lot of girls her age are doing stuff with boys that she doesn't want to do or feels ready for so yeah, I can see how being her right now might feel pretty crap.She tends to focus on all of the negatives and doesn't really want to see the positives like how clever she is, how talented(she sings) (is athletic) , how popular she is and has boy mates as well as girl mates.How secure her home life is, how we don't put pressure on her(or try not too) how we try and support her.

[lostinteaching47]

I think she also feels anxious about where we live, it isn't particularly nice and she doesn't always feel safe.She used to like being at home but now she says she doesn't as relaxing(at home) makes her chest start hurting.She worries about things like Conspiracy theories and last year it was the Olympics and the Illuminati, it's probably normal teenage stuff but being my 1st teenager I don't really know.I think with teenagers they get swept up with the hysteria (possibly)She was really stressed with the riots the other year and she hates hearing about bad weather like floods and stuff.I worry and have had panic attacks in the past.

[OhYouBadBadKitten]

An echo looks at the structure of the heart using ultrasound. An ECG looks at the electrical signals.

[lostinteaching47]

O'h o.k, I was right 1st time, no she hasn't had one of those.We were in the Paeds A&E so just had the ECG monitor brought to us on a trolley, then it was left there for an hr+ before a nurse could come and do it, but they were very busy and I knew DD wasn't an emergency.

[Hawkmoth]

Anaemia? Has that been ruled out? I get palpitations when mine is bad.

[Selks]

She does sound very anxious. In addition to any physical health checks continuing I would suggest that you request your GP to do a referral to CAMHS for assessment and treatment of her anxiety. The chest pains may or may not be related to this. She may benefit from CBT (cognitive behaviour therapy) which CAMHS may be able to offer.

You describe her as 'very slim', exercising a lot and sometimes skipping meals. There may be nothing to be alarmed with this but please do get her weight checked and BMI calculated by the GP so that you know that weight / eating issues are not involved with any of this.

Disclaimer - I'm a CAMHS clinician.

[lostinteaching47]

Thank you selks for your viewpoint.I think she is on the skinny side, she is almost as tall as me (I'm 5ft 6) and she's a size 8 I reckon.

Can I ask would the school need to know about this as when I suggested she saw someone in the school, i.e the school nurse/a counsellor type person she was adament she didn't want to.She has had 2 friends that were self harming and one with an eating disorder that her school got involved with and she feels they have not handled it very well.She is scared it will get out and people will know her buisness.

[lostinteaching47]

Hawkmoth(beautiful nickname :>) ), I was thinking anaemia before, she may well be.

[lostinteaching47]

Thank you everyone for your thoughts on this, you have all helped to clarify my thinking.I am not panicing as much now but am petrified of CAMHS as when my youngest was 3 and a bit we had to have family therapy and it was a nightmare, it didn't go well at all so I guess I didn't want to go back there but if my daughter needs it I will.

[Selks]

Sorry to hear that the family therapy didn't work out for you Lostinteaching, but your experience might be different this time - different clinician and situation etc.

Schools don't have to know if CAMHS is involved, but sometimes it can help if they do, but you can discuss your feelings on this with CAMHS if you do see them.

[Selks]

Also as well as getting weight / BMI checked at the GP I would recommend getting a blood test done to check for anaemia and to check she is generally healthy.

[sashh]

It is very very unlikely that it is her heart.

Anything congenital should have been picked up as a child and she is too young to develop coronary artery disease.

She needs the 24 hour ECG, a chest x-ray and an Echo.

Your DR should also be considering lung function tests.

It is most probably stress but you need to test to rule everything out.

The 24 hour ECG - well your heart rate fluctuates all day, a 24 hour ECG will show any abnormal rhythms.

The echo, as has already been said, looks at the structure of the heart and how the blood flows through the valves.

A chest X ray will show anything major with the lungs.

Lung function tests can tell you if she has asthma or other lung disease.

Now please don't think I'm being flippant, but does her bra fit?

I once fitted a 24 hour ECG to a lady who had mystery chest pain. She'd had the X-Ray and echo.

When the tape is fitted you have to remove your bra, you can then put your bra back on.

This particular lady decided to go 24 hours bra less. Her chest pain disappeared that day. Her bra was too tight, but no one thought to ask that. You wouldn't would you?