Author: Kathleen Kinderwater, MD
Co Author #1: Megan Ferderber, MD, CAQSM, FAAFP
Senior Editor: Jessalynn Adam, MD
Editor: Nathan Cardoos, MD

Patient Presentation:
18 year-old African American male collegiate basketball player presents with sudden onset chest pain, dyspnea, headache and near syncope.

History:
Prior to the COVID-19 pandemic, an 18 year-old African American male collegiate basketball player with a history of exercise-induced asthma developed sudden onset chest pain, dyspnea, headache and near syncope during a challenging conditioning practice. He was able to hold onto teammates as they lowered him to the court and his athletic trainer reported no apparent loss of consciousness. He was transported to the Emergency Department by ambulance. In the ED, he reported a history of similar episodes that were attributed to his asthma. Family history was notable for a brother with an enlarged heart and mother with thyroid disease. A recent pre-participation physical performed at an urgent care facility was normal

Physical Exam:
VS: BP 125 systolic 69 diastolic, HR 70, RR 20, Temp 98.6 F
General: Well appearing in no acute distress.
HEENT: Normocephalic atraumatic. Moist mucous membranes. Vision intact, extraocular motions intact.
Cardio: Regular rate and rhythm. Normal heart sounds. No murmur, friction rub, or gallop. Normal pulses.
Pulm: Effort normal. No tachypnea, accessory muscle usage or respiratory distress. No wheezing, rhonchi, or rales.
Abd: Soft, non-distended. No tenderness, guarding or rebound.
MSK: Neck with full painless range of motion. No stigmata of Marfan. Beighton score 4 out of 9 for hyperextension of bilateral small fingers and knees

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