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

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.