Tele-triage for Chest Pain in Children

Audience: pediatric

Chest pain in children can be frightening but is often not caused by heart problems. Telemedicine can help assess symptoms quickly and guide families on the next steps. This service allows healthcare providers to evaluate the child's symptoms remotely, saving time and reducing unnecessary visits. However, some signs require urgent in-person care. Tele-triage helps identify these red flags and ensures children receive timely and appropriate treatment. It is important to prepare for the tele-visit by noting symptoms and any changes in the child's health. After the tele-visit, families may be advised on home care or directed to emergency services if needed. This guide explains when telemedicine is suitable for chest pain in children and when immediate medical attention is necessary.

Red flags — go in person / ER

• Chest pain accompanied by difficulty breathing or bluish lips — seek emergency care immediately.
• Chest pain lasting more than a few minutes or worsening over time — get urgent medical evaluation.
• Fainting, severe dizziness, or rapid/irregular heartbeat with chest pain — call emergency services right away.

What telemedicine can do

• Initial symptom assessment for mild or unclear chest pain.
• Review of medical history and risk factors related to chest pain.
• Guidance on home care and monitoring symptoms.
• Determining need for in-person evaluation or emergency care.

What telemedicine cannot do

• Physical examination including heart and lung auscultation.
• Electrocardiogram (ECG) or other diagnostic tests.
• Emergency interventions for severe or life-threatening conditions.
• Treatment of serious cardiac or respiratory emergencies.

Understanding Chest Pain in Children

Chest pain in children is common but usually not related to heart disease. Causes often include muscle strain, respiratory infections, or anxiety. Less often, it may signal a more serious condition. A healthcare provider will ask about the pain's location, duration, and any other symptoms to understand the cause better.

When to Use Telemedicine for Chest Pain

Telemedicine is useful for initial evaluation of chest pain in children. It allows doctors to review symptoms, medical history, and risk factors remotely. This can help decide if home care is sufficient or if the child needs to be seen in person. Tele-triage can quickly identify mild cases and reduce unnecessary emergency visits.

Red Flags That Require Immediate In-Person Care

Certain signs mean the child needs urgent medical attention. These include:

If any of these occur, call emergency services or go to the nearest emergency room immediately.

Preparing for a Telemedicine Visit

To get the most from a tele-visit:

What to Expect After the Tele-Visit

After the telemedicine appointment, the provider may:

Families should follow these instructions carefully and keep track of any changes.

Limitations of Telemedicine in Chest Pain Evaluation

Telemedicine cannot perform physical exams, heart monitoring, or imaging tests. If the provider suspects a serious condition, they will advise immediate in-person evaluation. Tele-triage is a helpful first step but not a replacement for emergency care when needed.

How to prepare for your tele-visit

• Note the time chest pain started and how often it occurs.
• Describe the pain type (sharp, dull, constant, intermittent).
• List any other symptoms (fever, cough, palpitations).
• Have the child's medical history and current medications ready.
• Ensure a quiet, well-lit space with a stable internet connection.
• Have a caregiver present to assist during the tele-visit if possible.

After your tele-visit

• Follow provider's recommendations for home care or monitoring.
• Schedule follow-up appointments if advised.
• Seek immediate care if red flag symptoms develop or worsen.
• Keep a symptom diary to report any changes to healthcare providers.
• Maintain communication with your healthcare provider for ongoing concerns.

FAQs

Can chest pain in children be serious?

Yes, while most chest pain in children is not serious, it can sometimes indicate a serious condition. Red flags such as difficulty breathing, fainting, or chest pain after injury require immediate medical attention.

Is telemedicine safe for evaluating my child's chest pain?

Telemedicine is a safe and effective way to assess mild or unclear chest pain symptoms. It helps determine if your child needs urgent in-person care or can be managed at home.

What should I do if my child's chest pain worsens after a tele-visit?

If your child's chest pain worsens, or if new symptoms like difficulty breathing or fainting occur, seek emergency medical care immediately.

How can I prepare my child for a telemedicine visit?

Prepare by noting symptom details, having medical history and medications ready, ensuring a quiet space with good internet, and having a caregiver present to help during the visit.

Can telemedicine replace emergency care for chest pain?

No, telemedicine cannot replace emergency care. It helps identify when urgent evaluation is needed but cannot provide emergency treatments or physical exams.

Sources

1. Chest Pain in Children — MedlinePlus | U.S. National Library of Medicine / National Institutes of Health.
2. Chest Pain in Children: Overview — American Academy of Pediatrics (AAP).
3. Chest Pain: When to Worry — Mayo Clinic.
4. Telemedicine: What You Need to Know — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational and triage purposes only and is not a substitute for in-person medical evaluation and treatment. If your child has severe symptoms or you are concerned about their health, seek emergency care immediately.