- 1st step is considering the diagnosis – All that Wheezes is not asthma
- Alternatives to reactive airway disease may be difficult to diagnosis; remember that vital signs are VITAL
- Myocarditis and pericarditis are rare but important causes of pediatric chest pain and important causes of morbidity/mortality in the pediatric population.
- Consider myocarditis with new onset CHF or arrhythmia – MUST assess Perfusion and palpate the liver for hepatomegaly. Skin mottling and an enlarged liver may be subtle, so you must be looking for it!
- Fear the grunting child!
- Identification and treatment of pericardial tamponade can be life saving. Remain vigilant and have a low threshold to "take a look."