Matters Of The Heart: Sports Clearance Physicals - Page #1

Author: Miriam Reece, MD
Co Author #1: Dr. Ken Taylor
Co Author #2: Dr. Suraj Achar
Editor: Kevin deWeber, MD, FAAFP, FACSM, RMSK

Patient Presentation:
An 18 year old male recruited to play Division I Water Polo presented for his pre-participation physical evaluation .

The patient's medical history was unremarkable. He had no surgical history, no allergies, and was taking no medications or recreational drugs. ROS: A thorough ROS was unrevealing.
Specifically, there were no palpitations, chest pain, shortness of breath, presyncope, or syncope with exertion.
Family History: paternal grandfather with coronary artery bypass surgery in his seventies.

Physical Exam:
Well developed, well nourished male in no distress. Vital signs were normal except the palpated pulse was irregular. Cardiac exam revealed an irregularly irregular rhythm at 54 bpm with a normal S1 and S2, and no S3 or S4. Normal PMI. No murmur heard standing, sitting, supine, or with valsalva. No rubs appreciated.
The remainder of the exam was normal.

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