Evaluation and Management of Pediatric Chest Pain, Syncope, and Murmur in the Emergency Department
The three most common reasons for referral to the cardiologist’s office for new patients are chest pain, syncope, and a heart murmur. These same three complaints or findings are frequent reasons for children to be brought to an emergency room or urgent care facility. In this chapter, typical cases for each are presented followed by a guide to the workup and management of each. As most of these will be non-cardiac in origin, it is important to distinguish the common non-cardiac causes from the uncommon true cardiac etiologies and to know when to intervene or contact cardiology urgently for the latter. Algorithms for the evaluation and management for each are provided.
KeywordsChest pain Syncope Heart murmur
- 4.Rudolph CD, Mazur LJ, Liptak GS, Baker RD, Boyle JT, Colletti RB, Gerson WT, Werlin SL. Guidelines for evaluation and treatment of gastroesophageal reflux in infants and children: recommendations of the North American Society for Pediatric Gastroenterology and Nutrition. J Pediatr Gastroenterol Nutr. 2001;32:S1–31.CrossRefGoogle Scholar
- 15.Olshansky B, Shen WK, Calkins H, Brignole M. 2015 Heart Rhythm Society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart Rhythm. 2015;12(6):e42.Google Scholar