Author: Grover Chase Wilson, MD
Co Author #1: Ramon Ylanan, MD
Co Author #2: Jason Stacy, MD
Editor: Suraj Achar, MD
An 18 year old black female collegiate basketball player presented with palpitations for four days. Palpitations were accompanied by dyspnea and fatigue. Episodes occurred with rest and exertion.
The patient had a history of palpitations nine months prior, but the symptoms had resolved spontaneously. Workup of the previous palpitations at another medical center yielded discovery of a patent foramen ovale and occasional premature beats, but no etiology of the patient's symptoms. The patient was allowed to resume full participation and had been asymptomatic until the current episode. She reported no cardiac history on pre-participation exam.
Vital Signs: Pulse-119, Blood Pressure-98/62, Respirations-16.
General: Fit, well-appearing black female.
Cardiovascular: Irregularly, irregular tachycardia. Normal S1 and S2. No murmurs, rubs, or gallops. Normal Point of Maximal Impulse. Symmetric 2+ pulses in all extremities. No edema.
Respiratory: No accessory muscle use. Clear to auscultation bilaterally.
Remainder of physical examination was unremarkable.
Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.