A 16-year-old male presented with three months of palpitations at rest, fatigue, and episodic pre-syncope; his paternal grandfather died following presumed premature myocardial infarction at age 30.He was seen Neff J1ACE4HN0B N50 7 Function Electric Built Under Double Oven and discharged one week previously at an outside emergency department (ED).He followed up with his pediatrician and was promptly referred to our pediatric ED for evaluation given his risk factors.Pertinent vitals on arrival were pulse 110, blood pressure 129/66, and oxygen saturation 97% on room air.
His exam was remarkable for a left upper sternal border 2/6 holosystolic murmur with radiation to apex.In addition, the patient had a chest radiograph (Figure), a nonspecific Ranch Rope but abnormal EKG, and a point-of-care ultrasound (POCUS) of the heart performed.