As the pandemic rolls on, pediatric cardiologists are seeing an increasing number of young patients seeking medical attention for chest pain, heart palpitations and lightheadedness. Experts attribute these symptoms to stress, and look to the upheaval caused by COVID-19 as the culprit.

“Chest pain in adults is almost always concerning,” said Elaine Maldonado, MD, pediatric cardiologist and interim division chief in the Department of Pediatrics. “But in teenagers, it is almost always not heart-related.”

These stress-induced symptoms were fairly common before the pandemic, said Dr. Maldonado, who reported seeing about one-third of new patients exhibiting heart palpitations and chest pain prior to COVID-19. But now, teenagers seeking medical attention for these symptoms have increased to nearly half of her new patient visits, she said.

Barring a family history of young people with heart conditions, bad habits like smoking or symptoms occurring during exercise, these symptoms, while frightening, are typically nothing to worry about — for heart issues at least.

What is concerning is the amount of stress teenagers are feeling, often without realizing it.

“When they come to see me, they are under the assumption that we are going to find something wrong with their hearts,” Dr. Maldonado said. But after a thorough assessment, these symptoms almost always uncover increased stress and neglect of routine self-care.

“The hard part for everyone to associate sometimes is that your mental health and the way you treat your body is going to impact how you feel and how your body treats you,” Dr. Maldonado said.

The disruption of the pandemic has caused huge shifts to everyone’s routines, especially to eating, exercise and sleeping habits, she said. With teens on the computer all day because of distance learning, they aren’t remembering to exercise or drink enough water, and many aren’t sleeping well.

“It’s all this common-sense stuff that they aren’t keeping track of,” Dr. Maldonado said. “And you know they’re teenagers, so we can’t blame them. A lot of it is parental responsibility right along with them.”

Dr. Maldonado advises avoiding caffeine and sugary drinks, getting regular exercise, drinking plenty of water and turning devices off before bedtime. She notes that it can be a struggle for both teens and adults to incorporate these healthy habits into their lives.

“I don’t want to trivialize any of these symptoms for these young patients. It’s very important to them and their parents, and it can be scary,” Dr. Maldonado said. “But I also don’t want to trivialize how important it is to just take care of yourself and for parents to help their teens understand what that means. Sleep right, eat right, drink lots of water, exercise everyday —those are all very common-sense things, but they’re also things that adults forget. To expect it of our teenagers, we need to expect it of ourselves.”