Pediatric Cardiac Emergencies: When to Worry and When to Reassure

Cardiac symptoms are a frequent reason for pediatric patients to present to the emergency department. As stressful as these visits can be for both parents and inexperienced providers, many of these symptoms may have a benign explanation, and recognition of red flags are of the utmost importance to provide optimal care. In this article, we present four clinical scenarios that have a cardiac etiology and are common to the pediatric emergency department. In addition to highlighting differential diagnoses, we discuss important red flags, key signs, and findings on physical examination that should not be missed. A brief review of important workup and management is also discussed. Lastly, we review common electrocardiogram pearls and pitfalls important for the ordering provider to recognize. In this article, we hope to provide guidance on when to provide reassurance and when to refer to a pediatric cardiologist for evaluation. [.