UMSL Associate Professor of Clinical Psychology Kamila White

Kamila White is an associate professor of clinical psychology at UMSL. (Photo by August Jennewein)

Imagine waking up to hear your child crying from chest pain. You rush to the emergency room. Dozens of tests later, you’re told there’s nothing physical causing the pain. Your child’s heart is functioning normally. The pain, however, continues. You feel helpless.

The number of reported cases of non-cardiac chest pain among children is on the rise, and Kamila White, associate professor of clinical psychology at the University of Missouri–St. Louis, is an expert on the phenomenon.

In 2009, White teamed up with Dr. R. Mark Grady, a pediatric cardiologist at St. Louis Children’s Hospital and Washington University in St. Louis. They began evaluating patients who’d been diagnosed with non-cardiac chest pain for a recently completed study.

“We looked at children 7 to 18 years of age,” she says. “These were children who had presented with chest pain but were screened negative for organic causes and by all accounts had a healthy heart.”

Along with UMSL graduate student Cassandra McDonnell, White assessed nearly 160 children and their caregivers. In addition, follow-ups with each child and caregiver were done three months after their first assessment.

“What was surprising to me was the severity of pain many children were experiencing and that even after being told their pain was non-cardiac related, when asked what they thought was causing their pain, most said their heart,” White says.

So what’s the cause?

In many cases, White says it could be emotional stress, anxiety issues or even mood related.

“We didn’t expect to see children this young, even though we only assessed children who were at least 7 years old,” she says. “There were cases of children much younger. Also, it was striking to see the degree of persistent pain many children experienced.”

One of the variables examined in this study was the degree to which chest pain interfered with children’s abilities to carry out normal childhood activities. In 63 percent of the cases, the pain interfered to some extent with a child’s ability to take part in activities, including playing sports and participating in gym class.

White says in some cases, the child was so worried or the pain so intense, that they did not participate in any activities out of concern for their chest symptoms.

Also, high anxiety levels in parents were linked with high levels of pain in the child.

“We found that children whose parents reported high anxiety experienced more chest pain interference than children whose parents reported less anxiety,” White says.

Non-cardiac chest pain in children remains relatively untouched and unstudied, according to White. She says she plans to continue her research and identify funding sources to support the development of treatment programs.

“My hope is that we can find ways to help support children with non-cardiac chest pain, but at this time, we just don’t know enough about this pain problem,” she says. “I’d like to see additional research on this topic and, ultimately, we need to find ways to develop interventions to help these children.”

Jen Hatton

Jen Hatton