Emergency Care for Infants and Children with Acute Cardiac Disease

Children occasionally present to the emergency department with life-threatening congenital or acquired cardiac disease. Presenting symptoms may be nonspecific, and accurate assessment and timely interventions are required to achieve optimal outcomes in this heterogeneous and complex patient population. In this article, we review 4 common scenarios: neonates presenting with ductal-dependent congenital heart disease, infants with tetralogy of Fallot who develop hypercyanotic episodes, children with decompensated congestive heart failure, and those with cardiac tamponade. In each instance, presenting signs and symptoms are discussed, and practical suggestions are offered for the initial diagnostic approach and management.