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A Viral Spiral - Page #1
 

Author: Waleem Hernandez, MD
Co Author #1: Kenzie Johnston, MD
Senior Editor: Kristine Karlson, MD, FAMSSM
Editor: Rahul Kapur, MD, FAMSSM

Patient Presentation:
A female lacrosse student athlete presented with lower extremity edema, palpitations, fatigue, lightheadedness, and gait instability.

History:
A 23-year-old Division I lacrosse athlete with a history of migraines, anxiety, and ADHD presented with bilateral lower extremity edema, intermittent palpitations, persistent fatigue, lightheadedness, and gait difficulty following a diarrheal illness in Colombia one month prior. Symptoms worsened with prolonged standing, stair climbing, and during play. The week prior to presentation, she was held from competition because of symptomatic tachycardia, pre-syncope, and transient vision changes. A diagnosis was made, and she was referred to neurology, cardiology, and infectious disease for further evaluation.

Physical Exam:
Vitals: supine 110/66 HR 70. Standing: 111/75 HR 88. 3 min standing: 113/74 HR 95. 5 min standing: 111/72 HR 98. Mild bilateral upper and lower extremity paresthesia with 3 minutes of standing. Mild headache with 5 minutes of standing. General: Well-appearing. Cardiopulmonary: Sinus bradycardia without murmurs, rubs, or gallops. Normal work of breathing. Lungs clear to auscultation . Abdominal: Soft and non-tender. Normal bowel sounds. Neurology: alert and oriented to time, person, place. Visual fields intact. No focal neurological deficits . Mild right hip flexor weakness (4/5). Staggering gait but ambulatory with assistance, walked on toes.

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NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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Phone: 913.327.1415


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