The Case Files: Syncope and Undiagnosed Addison's Disease

Bober, Wojciech DO; Levy, David DO; Rosenthal, Cynthia DO A 15-year-old girl was brought by her mother to the emergency department with several days of weakness, non-bloody vomiting, and syncope. She had four syncopal episodes, all without premonitory symptoms. She had a past medical history of asthma, for which she was prescribed albuterol. She denied any past surgical history, allergies to medications, and taking any other medications. She denied complaints of chest pain, palpitations, and shortness of breath. Her temperature was 97.6°F, pulse 110 beats per minute, blood pressure 94/68 mm Hg, and respiratory rate 18 beats per minute with O2 saturation 97% on room air. She appeared pale, but was well developed and lying comfortably on a hospital stretcher. Her pupils were equally round and reactive to light and accommodation, sclera were anicteric, and she had no evidence of pallor. She had a normal pharynx without erythema or exudates, and her mucous membranes were somewhat dry. Her neck was supple, nontender, and without lymphadenopathy or meningitic signs. Her heart was tachycardic but regular without murmurs, rubs, or gallops. Her lungs were clear to auscultation without wheezes, rhonchi, or rales. Her abdomen was soft with normal bowel sounds, nontender, and nondistended. Her extremities were nontender to palpation, and were without edema or erythema; capillary refill was less than two seconds. Her skin examination was unremarkable except for slight darkening of the ve...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research