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Q. My 8-year-old son gets chest pain for the past six months. Please interpret his CT scan.

Answered by
Dr. Sagar Ramesh Makode
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jun 13, 2020 and last reviewed on: Jun 29, 2020

Hello doctor,

My 8-year-old son has been having chest pains since six months. He takes medication for acid reflux, anxiety, and asthma currently. We had a CT scan done but the doctor says it should nothing to be concerned about, however, some of the stuff in the report I feel is of concern and I am looking for clarification on some things.

He is currently on Omeprazole, Levabuterol, Atomoxetine, Flovent, and Guanfacine.

Dr. Sagar Ramesh Makode

Cardiology General Medicine Internal Medicine
#

Hello,

Welcome to icliniq.com.

I have gone through the CT report (attachment removed to protect patient identity).

There are variations in the branching pattern, but this is fine to have. Many individuals have such a branching pattern without any consequences. Slight bulging was mentioned at ramification, but they also commented that it appears to be within normal limits. And such slight bulging would not cause pain or would not have any consequences unless there is any obstruction within it.

Important is that there is no obstruction or abnormal course of left coronary artery. They have mentioned that the left coronary has a slightly high take off which is fine and unlikely to be responsible for symptoms or complications. So, as far as coronaries are concerned, they are unlikely to be responsible for his symptoms and unlikely to end up in any adverse consequences. Now I guess, he must have had an ECG and echo, which would give additional assurance to this.

Now if according to symptoms, they are again not classical of heart. If they were cardiac then they would have certainly aggravated by activities. So unlikely to be a cardiac issue.

Now considering his reflux issue, the first possibility should be considered of acid reflux and secondly of musculoskeletal even if there is no definitive demonstrable tenderness. Omeprazole may not be able to counteract reflux totally. So it is worthwhile to try locally acting agents like syrup Sucralfate and see if it helps. Light meals and some walking after meals. Locally acting agent Diclofenac gel may also be tried.

I hope this helps.


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