A Prescription For Exercise Avoidance

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A Prescription For Exercise Avoidance - Page #1

Author: Bradley Changstrom, MD Co Author #1: Valle J Co Author #2: Blaker B Co Author #3: Stauffer B Patient Presentation: A 26 year-old recreational female runner with history of ADHD was evaluated after developing chest pain, dyspnea and palpitations during a 5-mile training run. History: Her symptoms developed near the end of her run and did not resolve with rest. After two hours, her chest tightness and palpitations progressed and she presented to the emergency department. She denied recent illness, fevers, chills, orthopnea, syncope, calf pain, bleeding disorder or edema. She denied illicit drug use or tobacco use. She admitted to infrequent alcohol use. She uses prescription amphetamine-dextroamphetamine occasionally, but none recently. She denied any family history of sudden cardiac death or structural heart disease. Physical Exam: Vital Signs: Temperature 98.4 Blood pressure of 140/90, pulse 225, respiratory rate of 16 and oxygen saturation of 98% on room air. Gen: Mildly distressed due to chest pain. HEENT: No proptosis or conjunctival pallor. Neck: Supple, no lymphadenopathy or thyromegaly. Cardiovascular: Tachycardic with regular rhythm. No JVD. No S3 gallop or murmurs. No lower extremity edema. Pulmonary: Clear to auscultation bilaterally. Abdomen: Soft, non-tender. No hepatosplenomegaly. Skin: No rashes. Neurologic: Normal cranial nerve testing, normal strength, normal reflexes and normal sensation. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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