Lab/ECG/Xray Rounds. The EM Resident Provisionally Known as Sean Caine CCFP-EM March 5, 2008. Case. 29 yo male presents with severe lightheadedness and palpitations during sexual activity Symptoms persisted x 10-15 min Spontaneous resolution. Case continued. Additional hx:
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The EM Resident Provisionally Known as Sean Caine
March 5, 2008
29 yo male presents with severe lightheadedness and palpitations during sexual activity
Symptoms persisted x 10-15 min
2 prev visits to ED in past month for similar symptoms
Lightheaded while mowing the lawn
D/C home from ED after ECG and normal labs
Syncopal watching TV
Admitted for observation
Had serial cardiac enzymes and cardiac monitoring
Discharged home after negative work up
Instructed to f/u with GP
Normal vitals and physical exam
ECG is obtained….
Adam Davidson and Jeff Booker
Systolic motion of MV anteriorleaflet (SAM)
Mitral regurgitation (MR)Schematic
Previous hx of syncope
Family history of SCD or early onset of symptoms
????? physical activity
Distinguishing hypertrophic cardiomyopathy (HCM) from "Athlete's Heart"
LV: left ventricle; LA: left atrium; LVH: left ventricular hypertrophy.Adapted from Maron, BJ, Pellicia, A, Spirito, P. Circulation 1995; 91:1596.