Pediatrics/7 year old with deep breathing and chest pain
QUESTION: 7 year old daughter has been breathing very deep, saying she feels like she can't breathe. When she has these mini episodes she says she feels a little pain in her chest, she gets very upset about it and it takes a while to calm her down. We've taken her to her pediatrician twice and they checked her out , said she sounded great. Lungs clear and heart sounds good & they think it could be a combination of anxiety and maybe reflux, although she says it doesn't "burn" but hurts. but maybe she doesn't know how to explain it to us. It seems to get worse at bed time or during anything that makes her anxious. She's always been a very anxious child but sometimes it will happen at random and she might also take some very deep breaths just randomly without even seeming to notice. She has minor asthma and pollen allergies. We treat her with zyrtec and singulair in the evenings for about a year now. Thank you in advance.
ANSWER: Hi, Dan,
This sounds like an anxiety/panic attack. This is not related to the asthma or allergies. About the only other thing I would think of doing would be to check a heart rate during an episode. If it is in the 200-250 range, than supraventricular tachycardia can present like this. This is unlikely. Far more likely is a panic attack. Discuss this with your doctor.
Good luck, Dr. Olson
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QUESTION: Thank you very much for the quick response. I have checked her heart rate during the episode and it seems normal. The pain is what concerns me. Is that normal for panic/anxiety? And why would it come on so suddenly like this when she's not had a history of panic attacks & what causes this? It appears to happen when she's not under any particular stress. The past few days she has not had another attack, but she has continued to breathe very deep every few breaths she takes. The other thing I didn't mention is that she is very sensitive to any pain at all, she can't have a mosquito bite or tiny scrape without worrying to death about it, seems to have no pain tolerance at all. So I feel she could be blowing the chest pain way out of proportion during these attacks, and maybe the pain is just caused by the heavy non stop breathing during the attack.
Chest/abdomen pain is common in kids with panic attacks. Most of them are probably generated from thoughts within, rather than from external, easily identifiable sources. Again, hard to think of a heart or lung problem that would act like this. How much this really hurts her is debatable, but I think this is almost certainly a panic attack. Not much else really fits.
Have a good weekend, Dr. Olson