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