Author: Brad Bissell, MD
Co Author #1: Tanya Hagen
Patient Presentation:
An 18 year old senior high school distance track athlete developed chest pain during the end of a two-mile event.
History:
The patient developed chest pain but was able to finish the event. The pain initially occurred with exertion, then continued at rest and was associated with difficulty swallowing. There was no associated trauma. He had no shortness of breath, cough, nausea, vomiting, or abdominal pain.
Physical Exam:
Otherwise healthy, tall, thin male with a BMI of 19 in no respiratory distress. Vital signs within normal limits with a heart rate of 52, that is at his baseline. Cardiopulmonary exam is unremarkable without murmurs, rubs, or wheezes with clear breath sounds bilaterally. Abdomen is soft, non-tender, and without hepatosplenomegaly. He is neurovascularly intact at all four extremities.
Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.