History taking and physical examination of patients who present with cardiac pain are not generally regarded as part of an emergency nurse’s role in the UK. However, a good knowledge of the anatomy of the heart and cardiac disease, and the ability to undertake effective cardiovascular examination, could enable nurses to highlight adverse findings earlier in a patient’s journey and improve patient outcomes. This article reviews the anatomy of the heart and cardiovascular disease, and describes how to pick out the subjective and objective information from patient histories and cardiac examination to make differential diagnoses.

Documentation in healthcare services is important but often lacks detail. This article describes a pilot study of whether staff who have completed an emergency nurse practitioner course provide more detail in their patient assessments. Post-course audits demonstrate that standards of documentation had been maintained or had improved in some areas, but had declined in others.