My Heart, My Heart, Kickstart My Heart

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My Heart, My Heart, Kickstart My Heart - Page #1

Author: Evan Perez, MD Co Author #1: Joel Deleeuw, BA Co Author #2: Gerardo Vazquez, MD Co Author #3: Justin M. Wright, MD Patient Presentation: 26 yo Caucasian male 1st year medical student presented to clinic complaining of palpitations. The palpitations began during punching bag training. Clinic ECG showed wide QRS tachycardia. He was then escorted to the ER across the street. He had a CT angiogram showing no pulmonary embolism. He received adenosine with no improvement followed by verapamil. He was admitted for further monitoring. He was ultimately electrically cardioverted back to normal sinus rhythm and discharged on metoprolol without a definitive diagnosis. He remained asymptomatic for 2 weeks until he experienced palpitations, nausea, and dizziness while walking around and preparing for a medical school presentation. He presented to our ER for further evaluation. History: Past medical history - None (he played sports growing up and passed all pre-participation physicals). Family History - Negative cardiac family history. Social History - Denied alcohol, smoking, drugs and caffeine. Physical Exam: Vital signs: BP = 192/86; HR = 74; SpO2 = 100% RR = 20; Temp= 37.1C (98.8F) HT = 185cm (72.8 inches) WT = 81kg (178.2 pounds) General: Alert, mild distress Cardiovascular: Tachycardic, regular rhythm, no murmurs, 2+ pulses. No edema or JVD noted Respiratory: Lungs clear to auscultation, no respiratory distress or cyanosis Chest wall: No tenderness or deformities Neurological: No focal neurologic deficits, normal speech Skin: Warm and dry Psychiatric: Cooperative; appropriate mood and affect Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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