Chest pain and syncope in children: a practical approach to the diagnosis of cardiac disease.

Chest pain and syncope are common in children, accounting for numerous provider visits and leading to a considerable amount of testing.1-7 The Centers for Medicare and Medicaid Services projects that health care spending will exceed 20% of the US Gross Domestic Product by 2018.8 Considering the looming crisis in health care finance and impending changes in the US health care delivery system, provider-driven methods to optimize resource utilization are critical. Careful evaluation of current practices, with particular attention to use of expensive and overutilized resources, is needed.