Instructor-reported support needs and neurodevelopmental disorder diagnoses among children in Japanese judo: a cross-sectional survey across all Japanese prefectures.

Chest pain is a common complaint during childhood, and parents frequently visit pediatric emergency and outpatient departments out of concern for potential serious heart problems in their children (). Although chest pain caused by complex cardiac diseases in children is challenging to diagnose and treat, such conditions remain a central concern for parents (). Overly worrying about chest pain may increase children's anxiety, thereby exacerbating the pain symptoms (). Previous studies have shown that pediatric chest pain is usually non-cardiac in origin, with respiratory, gastrointestinal, psychological, musculoskeletal, and idiopathic causes being common. However, data from the Shihezi area of Xinjiang remain limited. Routine electrocardiograms and chest x-rays may sometimes fail to identify the cause, requiring further tests such as echocardiography and ambulatory electrocardiography to assess for possible cardiac conditions (). Therefore, detailed history taking, physical examination, and targeted auxiliary tests are essential components in the diagnosis and treatment of chest pain in children (). The etiological distribution of pediatric chest pain may vary according to study setting, referral pattern, diagnostic strategy, and local healthcare practice (). This study aims to analyze the distribution of causes and clinical features of chest pain in adolescents and children in the Shihezi area of Xinjiang, providing a basis for improving local diagnostic and therapeutic levels. A total of 243 non-traumatic chest pain patients aged 8-17 years who visited the Pediatric Emergency and Outpatient Department of the First Affiliated Hospital of Shihezi University from January 2023 to December 2024 were selected. Data on their medical history, physical examination, laboratory tests (such as complete blood count, inflammatory markers, myocardial biomarkers, etc.), and imaging studies (such as chest x-ray, electrocardiogram, echocardiogram, coronary CTA, etc.) were collected. Exclusion criteria were: (1) traumatic chest pain patients; (2) patients younger than 8 years or older than 17 years. A retrospective review of the clinical data from 243 patients was conducted: the average age was 12.61 ± 4.38 years, with 87 male patients (35.8%) and 156 female patients (64.2%). The average weight was 51.26 ± 12.72 kg, and the average BMI was 20.83 ± 3.17 kg/m. Chest pain intensity was recorded using the Numerical Rating Scale (NRS), an 11-point scale (0 = no pain, 10 = worst possible pain). A clear etiology was identified in 166 cases, which included: