Chest pain is a common complaint in pediatric patients, and parents often think that their child has a heart problem. In fact, chest pain is less common in children due to heart problems and is mostly caused by non-cardiac diseases. Identification of causes (a) Heart disease 1. Structural abnormalities of the heart Some structural abnormalities of the heart can cause chest pain, such as aortic constriction, pulmonary stenosis, aortic aneurysm, coronary artery lesions, valvular lesions and cardiomyopathy, etc. 2.Heart inflammation including pericarditis, myocarditis and endocarditis, etc. 3.Cardiac arrhythmias Rapid arrhythmias and bradycardia. (2) Non-cardiac diseases 1, chest wall Chest wall trauma, muscle and tendon injury during exercise, costochondritis, chest skin inflammation, and even breast development and breast inflammation can cause chest pain. 2, thoracic mediastinum Pleurisy, pneumothorax, thoracic and mediastinal tumors, etc. 3, respiratory diseases Airway obstruction, airway inflammation caused by cough shortness of breath can cause chest tightness, chest pain. 4.Gastrointestinal tract and abdomen Esophagitis, gastrointestinal inflammation, subdiaphragmatic abscess. 5.Other circumstances that are difficult to determine, such as intercostal neuralgia, mental factors, emotional problems, etc. Clinical experience 1.Detailed medical history Time of chest pain, nature of pain, frequency of pain, duration of pain; whether there has been any recent trauma or strenuous exercise; whether there are other accompanying symptoms, such as fever, cough, history of syncope, etc. 2.Meticulous physical examination Whether there is shortness of breath, chest pressure, pericardial and pleural friction sounds, arrhythmia and heart murmur, and whether deep and loud breathing or shoulder movement aggravates chest pain. 3.Auxiliary examination Chest X-ray, cardiac ultrasound and electrocardiogram can be routinely performed to further clarify the diagnosis. 4.Follow-up observation will be conducted if no lesion is found through physical examination and auxiliary examination.