All Posts Tagged With: "syncopal episode"

Link: http://journals.lww.com/em-news/Fulltext/2005/11000/Lyme_Carditis__From_Asymptomatic_First_Degree.9.aspx

Excerpt:

A previously healthy 17-year-old girl was brought to our ED after a syncopal episode that occurred while she was standing in her kitchen earlier that evening. According to her mother, who was speaking to her at the time of the episode, she suddenly dropped to her knees and then lost consciousness for approximately 10 to 20 seconds. When she regained consciousness, she quickly returned to her baseline mental status, denying any confusion or lethargy. In fact, during our interview with the patient, she reported feeling great immediately after this event.

Her ECG showed an accelerated junctional rhythm with a rate of 120 beats per minute. Further history revealed that she had been seen by her pediatrician on the previous day for evaluation of a rash. She described the rash as it appeared that day as several erythematous patches approximately 5 cm to 6 cm in diameter that were located on her left forearm, abdomen, and thighs. She denied any previous skin conditions such as eczema or psoriasis, and could not recall any recent exposures to plants, ticks, new medications, or cleaning products. She was given a prescription for diphenhydramine, and aside from some general fatigue, was doing well up to the time of her syncopal event.

Full article: http://www.amc.edu/amr/archives/200606/case1.html

Excerpt:

A 52-year-old male marathon runner with a past medical history significant for glaucoma presented to the emergency department with a two-week history of increasing fatigue after an episode of syncope.

He initially presented to his primary care doctor’s office complaining of flu like symptoms one week after running a marathon and three weeks prior to admission. He described fever, chills, night sweats, increasing fatigue and body aches. He was noted to be an avid runner who had finished within the top five to ten athletes in prior marathons. He stated that despite training intensely, he only finished in 50th place. During this visit, a chest x-ray was obtained which showed no evidence of pneumonia or other abnormalities. He was diagnosed with a minor viral upper respiratory tract infection and over the following week began to notice improvement of his symptoms.

He returned to the office two weeks after the initial visit with worsening fatigue and decreased exercise tolerance. He had become increasingly short of breath after running more than 2 milles. A serologic test for Lyme disease was performed to rule out Lyme carditis after an EKG showed first-degree heart block.