Calling Timeout For A Heart On A Fast Break

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Calling Timeout For A Heart On A Fast Break - Page #1

Author: Corey Spector, DO Co Author #1: Ben Reisz, ATC Co Author #2: Ankit Shah, MD Co Author #3: Korin Hudson, MD Senior Editor: Drew Duerson, MD Editor: Molly McDermott, DO Patient Presentation: A healthy-appearing 18-year-old male with no relevant past medical history presented for a sports preparticipation physical examination. History: An 18-year-old male NCAA Division 1 athlete presented for cardiac evaluation after experiencing episodes of shortness of breath during practice that resolved with coughing. During his pre-participation screening history, he denied significant past medical history. He was a multisport athlete in high school and denied any history of syncope, chest discomfort, dizziness, lightheadedness, or palpitations during exercise. He had no known family history of cardiovascular disease. During pre-participation screening, a stress test documented supraventricular tachycardia lasting 20 seconds at approximately 250 beats per minute post-exercise. In retrospect, the patient acknowledged having similar sensations during exercise previously, terminated by coughing, but not realizing this was abnormal. Physical Exam: Vital Signs: Blood Pressure 139/62 mmHg, Heart Rate 65 beats per minute, SpO2 99% on room air, Respiratory Rate 14 breaths per minute General: No acute distress. Neck: No jugular venous distention. Cardiovascular: Regular rate and rhythm, no murmur, gallop, or rub. No pectus deformity. Lungs: No respiratory distress. Lungs clear to auscultation with no wheezing or crackles. Pulse check: Femoral and distal pulses were 2+ without bruit Musculoskeletal: No gross deformity of extremities. Full range of motion. No swelling. Skin: Warm, dry, pink Neurologic: Sensation intact to light touch. No focal motor deficits. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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