Brugada Group 6 Ateneo School of Medicine and Public Health

HISTORY

MS 25 years old Male Filipino Roman Catholic Pasig City Informant: Self Reliability: Very Good General Data

Loss of consciousness Chief Complaint

30 minutes PTA Riding a motorcycle with companion Chest discomfort described as tightness, diffuse, non- radiating, 6/10 severity with associated dyspnea lasting 30 seconds Stopped bike on sidewalk where vision dimmed Loss of consciousness lasting 2 minutes No headache, vomiting, dizziness, weakness, numbness No stiffening of extremities or drooling History of Present Illness

28 minutes PTA Pt regained consciousness, was diaphoretic Chest pains continued Was picked by a serendepititiously located RedCross van and rushed to TMC History of Present Illness

General ◦(-) Fever, (-) Weight changes, (-) Fatigue Musculoskeletal/Dermatologic ◦(-) Itching, (-) Muscle/joint pains, (-) Rashes HEENT ◦(-) Vision/hearing problems, (-) Epistaxis/gum bleed, Respiratory ◦(-) Hemoptysis, (-) Cough, (-) Wheezing Review of Systems

Cardiovascular ◦(-) Orthopnea, (-)PND Gastrointestinal ◦(-) N/V, (-) Dysphagia, (-) Heartburn, (-) Change in bowel habits, (-) Rectal bleed, (-) Jaundice Genitourinary ◦(-) Nocturia, Dysuria, Frequency, Hematuria Endocrine ◦ (-) Heat intolerance, (-) Polyuria, (-) Excess thirst, (-) Cold intolerance Review of Systems

Nonspecific abnormal ECG, 2008 For pre employment Initially diagnosis unrecalled ECG repeated which turned out normal Head trauma, January 2010 Sustained while lifting machinery Causing bleeding, necessitating stitches No loss of consciousness, vomiting, or neurological sequelae Past Medical History

(+) Asthma, father's side (+) Hypertension, father's side (+) Myocardial infarction, father's side (+) DM, mother’s side (+) Stroke, mother’s side (+) Leukemia, mother's side (-) PTB, Kidney Disease Family History

College graduate Systems developer Cohabiting, no children Current smoker (2 pack years) Occasional alcohol beverage drinker (3 / month max 3 bottles) No history of illicit drug use Personal/Social History

PHYSICAL EXAMINATION

General ◦Alert, coherent ◦Height 166 cm, Weight 68 kg, BMI 24.7 Vital Signs ◦BP 110/80, HR 88, RR 19, T 37.1 C Skin ◦pink, no rashes/scars/lesions Physical Examination

HEENT ◦Normocephalic ◦Anicteric sclerae, Pink palpebral conjunctivae ◦Moist pink lips, pink buccal mucosa ◦(-) Nasal discharge, (-) facial tenderness ◦(-) TPC, (-) CLAD, non distended neck veins Physical Examination

Respiratory ◦Symmetric chest expansion ◦Resonant chest wall ◦(-) Rales, rhonchi, wheezes Cardiovascular ◦PMI 5th ICS LMCL ◦Normal rate, regular rhythm ◦Distinct S1 and S2, (-) Murmurs Physical Examination

Abdominal ◦Flat abdomen ◦Normoactive bowel sounds ◦Tympanitic on percussion ◦No tenderness on light and deep palpation ◦No organomegaly Extremities ◦Full and equal pulses ◦CRT <2s, no cyanosis Physical Examination

Neurologic ◦Cranial Nerves intact ◦Motor 5/5 on upper and lower extremities ◦Sensory - no deficits Physical Examination

CBC Electrolytes Thyroid Function Tests CKMB, CKMM, CK Total PT, PTT Creatinine, Uric acid, Lipid Profile CBG: 97 Diagnostics

PEFR Measurements NebulizationBest PEFRPercent Best (350) Pre % % % %

PARAMETERRESULTNORMAL VALUES Hgb g/L Hct RBC WBC x 10^9/L PC x 10^9/L Differential Neutrophil Lymphocyte Monocyte Eosinophil Complete Blood Count

PARAMETERRESULTNORMAL VALUES Na141 K3.0 Mg1.85 Ca5 Creatinine.84 Uric acid6.61 APTT PT PTT Blood Chemistry

PARAMETERRESULTNORMAL VALUES CK Total337.2 CK MM304.7 CK MB32.7 Trop TNegative TSH3.4 FT33.01 FT41.22 Blood Chemistry