Problem:
A 20-year-old female presents to a primary care office near her college. She requests an evaluation of a brief loss of consciousness (less than 1 minute in duration) during a tennis match for her college team yesterday. Her athletic trainer expressed concerns about a "syncopal episode." The patient recalls that her hometown medical provider had detected a murmur during a past sports physical, had ordered an echocardiogram, and prescribed Verapamil. She states that she was advised not to continue playing sports until she was evaluated by a cardiologist. Still, she didn't want to put her athletic scholarship at risk, so she never followed up with cardiology.