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- W3041444664 abstract "HISTORY: 19-year-old female DI field hockey player with PMH of fainting episodes presented to the training room after having a syncopal episode at the end of a game over the weekend and again at practice the day prior to presentation. In both cases, she describes having no warning before suddenly passing out. Both events were witnessed by her ATC who described her being unconscious for one minute, and then having horizontal nystagmus and a pulse of 100-130 bpm once conscious. She described lightheadedness, headache, and palpitations after each episode. She also felt groggy for one day after each event. She stated that it was very warm the day of the initial event with aggressive play, and eval by the sideline provider suggested dehydration. However, the second event occurred on a cool cloudy day during practice. Denied fever, chills, nausea, vomiting, tongue biting, bowel or bladder incontinence, visual or olfactory disturbances. PMH: Fainting episodes that started at the age of 13. ADHD FH: Father has narcolepsy with cataplexy Surgeries Tonsillectomy and adenoidectomy Meds Ritalin 10mg BID, Concerta 36 mg QD, and Trazadone 150mg QHS PHYSICAL EXAMINATION: Gen: alert, NAD Cardio: RRR, no murmurs Pulm: CTAB Abd: soft, non-TTP, no masses Ext: gait normal, moving all extremities symmetrically Neuro: CN II-XII intact, No focal deficits Skin: warm, dry, no rashes DIFFERENTIAL DIAGNOSIS: Vasovagal Syncope Epilepsy Electrolyte Abnormalities Cardiac etiology Narcolepsy TEST AND RESULTS: CBC w/ diff: WNL CMP: Glucose 110 2H Glucose Tolerance Test: Neg Sed Rate: WNL Anti-nuclear Ab: Neg CRP: 1.1 EEG: No epileptiform discharges identified ECG: NSR Echo: Mild regurgitation 14 Day Event Monitor: HR range: 62-178 bmp Sinus rhythm and sinus tachycardia MRI Brain: No acute ischemia or mass CTA Head/Neck: No high-grade stenosis, dissection, or pseudoaneurysm. Cardiac Stress Test: Neg Loop Recorder placed FINAL WORKING DIAGNOSIS: Narcolepsy with Cataplexy TREATMENT AND OUTCOMES:Due to the extensive negative work up, athlete has been allowed to return to activity with a slow progression and monitoring. Psychiatry is confident that narcolepsy is the likely diagnosis. Sleep study ordered to aid diagnosis, and results are currently pending." @default.
- W3041444664 created "2020-07-16" @default.
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- W3041444664 date "2020-07-01" @default.
- W3041444664 modified "2023-09-27" @default.
- W3041444664 title "Sudden Collapse - Field Hockey" @default.
- W3041444664 doi "https://doi.org/10.1249/01.mss.0000679704.71446.29" @default.
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