arrhythmias/cardiac arrest

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Cardiology

arrhythmias

cardiac arrest

Case History

A 22-year-old female presents for a routine physical examination at a general practice clinic. She is an avid recreational swimmer. She reports no personal history of cardiac symptoms such as syncope, chest pain, or dyspnea on exertion. However, her paternal aunt passed away suddenly at age 42 due to an undiagnosed cardiac condition. Her vital signs are within normal limits, with a blood pressure of 118/76 mm Hg and a pulse of 68 beats/min. Physical examination reveals normal heart sounds and palpable peripheral pulses. Given these findings, what are the most appropriate initial diagnostic evaluations and subsequent considerations for activity recommendations?

Lab Parameter	Value	Reference Range
Hemoglobin	135 g/L	120-150 g/L
Sodium	140 mmol/L	135-145 mmol/L
Potassium	4.0 mmol/L	3.5-5.0 mmol/L

A ) Counsel on symptomatic monitoring and allow unrestricted recreational activity.

B ) Initiate a 12-lead electrocardiogram and transthoracic echocardiogram, with a provisional recommendation for activity modification pending results.

C ) Refer to a general cardiologist for an immediate cardiac catheterization and electrophysiology study.

D ) Recommend annual follow-up with a primary care physician, without further immediate cardiac evaluation.

E ) Perform a routine cardiac stress test and advise on the importance of maintaining hydration during exercise.

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Lab Parameter	Value	Reference Range
Serum Potassium	4.1 mmol/L	3.5-5.0 mmol/L
Troponin I	0.08 ng/mL	<0.04 ng/mL
Arterial Blood Gas (ABG): pH	7.28	7.35-7.45
Arterial Blood Gas (ABG): PaCO2	55 mmHg	35-45 mmHg
Arterial Blood Gas (ABG): PaO2	78 mmHg	75-100 mmHg
Arterial Blood Gas (ABG): HCO3	22 mmol/L	22-26 mmol/L

Lab Parameter

Value

Reference Range

Serum Potassium

4.1 mmol/L

3.5-5.0 mmol/L

Troponin I

0.08 ng/mL

<0.04 ng/mL

Arterial Blood Gas (ABG): pH

7.28

7.35-7.45

Arterial Blood Gas (ABG): PaCO2

55 mmHg

35-45 mmHg

Arterial Blood Gas (ABG): PaO2

78 mmHg

75-100 mmHg

Arterial Blood Gas (ABG): HCO3

22 mmol/L

22-26 mmol/L