Life-Threatening Diagnosis or Completely Benign? A School Nurse’s Guide to Assessing and Caring for Students With Cardiac Complaints

Abstract

This article, developed in collaboration with pediatric cardiologists and school nurses, reviews common student complaints that may have a cardiac etiology including palpitations, chest pain, and syncope. We discuss the initial steps that a school nurse should perform for each of these complaints, including relevant history taking and physical exam. We identify red flags which should raise suspicion for a cardiac etiology and outline the initial steps a school nurse should take in managing these students. We discuss which cases require assessment with a bedside automatic external defibrillator and emergent contact of emergency medical services (EMS), less-emergent cases requiring EMS contact and transfer to the emergency department, as well as those occasions where the assessment suggests it is appropriate for a parent to pursue less-urgent outpatient evaluation by a primary healthcare provider or pediatric cardiologist.