Author: Jesse Coenen, MD
Co Author #1: Ed Reisman, MD
Co Author #2: Barb Brandon, MD
Co Author #3: Cheree Sauer ATC
Patient Presentation:
Nineteen year old female Division III college soccer player has experienced exercise-induced headache and lightheadedness for the past one year, as well as two episodes of presyncope (pallor, diaphoresis, vision blackout) while standing still.
History:
The athlete's past medical history was negative for cardiovascular disease. Past medical history is significant for non-Hodgkins lymphoma in remission. There was no family history of exercise intolerance or sudden death. Her only medication was combined oral contraceptive pill.
Physical Exam:
The athlete appeared well. Heart rate (HR) 71 and regular. Blood pressure (BP) 118/72. Cardiac auscultation revealed normal S1 and S2 with no murmurs. Point of maximal impact was non-displaced. 2+ peripheral pulses. Lungs clear to auscultation bilaterally. Neuro exam revealed no abnormalities.
Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.