Exercise 6: Before you progress to the next section read the case study below and answer the questions in the workbook.
Whilst meeting friends at a social event Pat noticed that a friend – Cameron was not looking too well. Pat sung your praises and advised him to see you at the surgery tomorrow. Which he did.
Cameron, a 26-year-old Caucasian man with no history of disease, came to see you after fainting yesterday at home. He was in his usual good state of health until he suddenly collapsed while washing up and lost consciousness for approximately 1 minute. He put it down to standing and the heat. He recovered spontaneously but you notice that he is slightly dyspnoeic.
He denies any associated chest pain or palpitations. No tonic-clonic activity was witnessed, and he experienced no incontinence.
Cameron is a computer programmer and he had been working 18 hours a day without rest periods for a month.
When you examined him there was no focal neurologic findings.
His heart rate was regular but tachycardic at 128 beats/minute.
His blood pressure was 126/72 mmHg without orthostatic changes, and his respiratory rate was 32 breaths/minute. The room air oxygen saturation was 90%.
Examination of his head and neck was normal. The results of chest wall examination revealed reduced breath sounds bilaterally at the lung bases. The findings of heart and abdominal examinations were unremarkable, but on examination of his legs swelling was noted in his left leg, and the left calf measured 3 cm more than the right one.