Syncope In The Athlete

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Syncope In The Athlete - Page #1

Author: Mitchell Peebles, DO Co Author #1: Jill Guillete, DO Co Author #2: Theodore Takata, MD Senior Editor: Heather Rainey, MD Editor: Jason Blackham, MD Patient Presentation: A 29-year-old-male presented to the Emergency Department following a syncopal episode while playing soccer. History: A 29-year-old male with no past medical history presented for evaluation after a syncopal episode to the ER. Recently, he had been experiencing intermittent left sided 5/10 chest discomfort. While warming up for a soccer game he became lightheaded and lost consciousness. He regained consciousness after a sternal rub. Family history was significant for a maternal uncle with a myocardial infarction in his thirties. With EMS, he received a 1,700 mL bolus of normal saline and 0.5 mg of Atropine for bradycardia and hypotension. During his hospitalization, he was found to have multiple episodes of nonsustained ventricular tachycardia (NSVT) and intermittent chest pain. Due to these episodes along with elevated high sensitivity troponins, he was taken for coronary angiography. Physical Exam: His vital Signs with EMS were 74/40, HR 60 and in in ED were 130/72, HR 77. Generally, he was in no acute distress and oriented to person, place and time. His cardiovascular exam showed regular rate and normal rhythm on auscultation without murmur, rub or gallop. His chest was clear to auscultation bilaterally Neurology: strength 5/5 bilaterally in both the upper and lower extremities. No focal deficits. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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