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Posted on 04/21/2010

47 yo male w/ no pmh p/w 2 weeks of palpitations and lightheadedness. Symptoms have been present intermittently for years but have been increasing in frequency over past 1-2 weeks. Pt was seen by PMD less than one week ago and told everything was normal. Pt reports symptoms primarily occur with exertion. When going up stairs or exercising, he begins to feels palpitations and then feels lightheaded and dizziness, like he is going to pass out. Usually lasts anywhere from 5-30 minutes and then spontaneously resolves. Palpitation described is a “fluttering-like” sensation. No CP/SOB. NO N/V/diaphoresis. No family h/o SCD. Pt denies excessive caffeine intake. No energy drinks or diet pills. No etoh/tobacco/cocaine/amphetamines use. No h/o anxiety/panic attacks. No h/o thyroid disease. At present, pt denies symptoms. The patient's VS: 98.3 HR 73 BP 140/81 sup RR 18 O2sat 100% RA FS109 The patient was in NAD with a normal heart, lung, abdominal and neuro exam. An EKG was performed. What is your diagnosis?

Case prepared by Dr. Sheehan, EM-1

 

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