A Case Of Presyncope In A Young Female Military Athlete

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A Case Of Presyncope In A Young Female Military Athlete - Page #1

Author: Matthew Kenney, DO Co Author #1: Jonathan Stoddard, MD Senior Editor: Kristine Karlson, MD, FAMSSM Editor: Christopher Ledford, MD Patient Presentation: A 23-year-old active-duty military female with no significant past medical history presented to the emergency department following a presyncopal event. The patient endorsed onset of severe dizziness with associated substernal, non-radiating chest pain and shortness of breath during the final event of her Army fitness test, a timed 2-mile run. The patient endorsed several similar episodes over the past 2 years, with onset during intense physical exertion, but had no prior medical evaluation for these concerns. History: She denied any history of palpitations or syncope. There was no family history of sudden cardiac death, coronary artery disease, cardiomyopathy, arrhythmias, or congenital heart disease. The patient reported intermittent use of nicotine vape. Social history otherwise non-contributory, including no use of alcohol, illicit drugs, or supplements. Physical Exam: The patient was well appearing with normal vital signs. Her cardiac exam revealed regular rate and rhythm with 2+ peripheral pulses and no murmurs on static or dynamic testing. She had no reproducible chest pain to palpation or movement. Her lungs were clear to auscultation with no wheezes, rhonchi, or rales. On neurologic exam, the patient was alert and oriented to person, place, and time, Cranial nerves were intact, with normal speech and no evidence of focal neurologic 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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