Rapid Rate In A Runner On Raceday - Page #1

Author: Justin Stumph, DO
Co Author #1: Mark Cipriani, MD

Patient Presentation:
Our patient is a 16-year-old male high school cross country athlete who was seen at the medical tent for chest pain and rapid heart rate following his race. He stated initial symptom onset was at the one mile marker, but he was able to finish the 3.1-mile race before being assisted to the medical tent. He reported symptoms of a racing heartbeat, chest discomfort, lightheadedness, shortness of breath, and nausea. He denied visual changes, numbness, tingling, or weakness. The patient and his mother were brought to the onsite ambulance where they shared his past medical history of Wolff-Parkinson-White syndrome treated previously with three cardiac ablations.

Patient has had symptomatic episodes of paroxysmal supraventricular tachycardia in the past and is aware when he enters this rhythm.

Physical Exam:
Vital signs: Heart Rate-177, Blood Pressure-116/67, Oxygen Saturation- 97 percent
General: Alert, oriented, and in mild distress
Skin: Pale, diaphoretic
Head: Atrauamtic
EENT: Pupils equal round and reactive to light, mucous membranes tacky, throat clear
Heart: Tachycardic without appreciable murmur
Lungs: Tachypnea without respiratory distress, lungs clear to auscultation without wheeze or crackles
Abdomen: Soft, nontender
Extremities: No cyanosis or swelling
Neuro: Cranial Nerves II-XII grossly intact, normal distal sensation

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