A young woman in her early 20s with syncope

Written by Pendell MeyersA 20 year old female with an episode of syncope was triage to my low acuity zone one morning. Her vitals were within normal limits except for her heart rate of 109 bpm.I immediately went to evaluate her, without looking in the chart first. I found a well appearing young lady in the room with her parents who witnessed the event. She stated that she was sitting on a shallow ledge in a pool when she became lightheaded, so she got up out of the pool and then briefly syncopized next to the pool in front of her parents, who were able to catch her preventing any trauma. She returned to normal within 30 seconds to a minute. She said she had never had any episode like this before. She denied having any symptoms before or after the event, and she was asymptomatic on my initial exam.After getting the story I asked about any known medical problems. They informed me that she had just been hospitalized 10 days ago for " some fluid around the heart " and was discharged after one day without incident.So I immediately left the room to get an ultrasound machine.As I rolled the machine back in the room, she suddenly became ashen and lethargic, then slumped back on the bed and was unresponsive but making some nonpurposeful movements and groaning. The cardiac monitor showedsinus rhythm but the automatic blood pressure cuff was not reading.While calling for some help and arranging to have her transported to our critical care zone, I got this quick ultrasound which confirme...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs