Chest pain as a manifestation of hypokalemia in a pediatric patient

Am J Emerg Med. 2018 Feb;36(2):342.e3-342.e5. doi: 10.1016/j.ajem.2017.11.001. Epub 2017 Nov 7.

Abstract

Patients presenting to the emergency department with chest pain are common and a cause of significant concern to patients and families and physicians alike. The causes of chest pain are myriad. These causes span diverse categories including cardiovascular, respiratory, abdominal and gastrointestinal, musculoskeletal, psychiatric, hematologic and oncologic, and neurologic Thull-Freedman (2010) [1]. These diverse etiologies present a diagnostic and management challenge to the ER physician who is tasked to minimize unnecessary diagnostics while not missing any significant disease. Multiple reviews have discussed the various etiologies of chest pain in the pediatric patient presenting to the ER but none of these recent reviews has included hypokalemia as a cause of chest pain Talner and Carboni (2000), Cava and Sayger (2004), Ringstrom and Freedman (2006), Foy and Filippone (2015), Yeh and Yeh (2015) [2-6]. Additionally, no reviews of hypokalemia describe this condition presenting with chest pain (Mandal, 1997; Gennari, 2002; Medford-Davis and Rafique, 2014 [7-9]). This case report describes a pediatric patient who presents with chest pain that was attributed to hypokalemia. This report attempts to make practitioners aware that hypokalemia may present with chest pain and to encourage ER providers to include this in the differential diagnosis.

Keywords: Chest pain; Hypokalemia; Pediatrics.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Chest Pain / diagnosis
  • Chest Pain / etiology*
  • Diagnosis, Differential
  • Electrocardiography
  • Emergency Service, Hospital
  • Humans
  • Hypokalemia / complications*
  • Hypokalemia / diagnosis
  • Hypokalemia / metabolism
  • Male
  • Sodium / metabolism*
  • Tomography, X-Ray Computed

Substances

  • Sodium