Patient case (clinical description): A 23-year-old man comes to the emergency department following an episode of syncope.  He was working out when he felt dizzy and passed out without head injury.  He has had 3 other episodes of light-headedness over the last year, all happening during physical activity. He never had this experience while resting. He has no other medical conditions.  The patient does not use tobacco, alcohol, or illicit drugs.  His father died suddenly at age 35.  Vital signs are within normal limits.  On physical examination, the patient has a harsh systolic murmur.  The lungs are clear with no peripheral edema. Echocardiography shows asymmetric interventricular septal hypertrophy.

Patient's own account: I'm 23, and I got admitted to the ER because I fainted all of a sudden. I was in the gym, working out, when all of a sudden, I just got dizzy and passed out. Hopefully, I didn't hit my head. It's not my first time having that kind of dizziness at the gym, never when I'm chilling at home tho. I don't have any special medical conditions and I'm not even smoking, drinking or doing drugs! My dad died suddenly when he was 35, so I'm kind of scared. My vitals were normal while at the ER and they did a physical exam and they told me my heart sounds abnormal. My lungs are ok, but I had to do an echography of my heart, and they told me it is bigger than average.

Clinical trial: Echocardiography Management for Patients Requiring Care for Non-Cardiac Surgery

Eligibility criteria:
Inclusion Criteria:

          1. Age ≥ 65 years

          2. Hypertension (HTN)

          3. Diabetes

          4. Obesity (body mass index [BMI] >35)

          5. Renal insufficiency

          6. Tobacco usage

          7. Hypercholesterolemia

          8. Sleep apnea/heavy snoring at night

          9. Clinical diagnosis of CHF as defined by:

               1. Dyspnea on exertion

               2. Paroxysmal nocturnal dyspnea

               3. Orthopnea

               4. Elevated jugular venous pressure

               5. Pulmonary rales

               6. Third heart sound

               7. Cardiomegaly or pulmonary edema on chest x-ray

               8. Peripheral edema

               9. Hepatomegaly

              10. Pleural effusion

         10. Palpitations/irregular heart beats

         11. Chest pain at rest and or exercise

         12. Murmur on examination

         13. Known coronary artery disease (CAD)/stents/coronary artery bypass graft (CABG)

         14. Known valvular disease

         15. Known stroke or transient ischemic attacks (TIA)

        Exclusion Criteria:

          1. Patients expected to say in the hospital for less than 24 hours.

          2. Inability of undergo TEE and TTE

          3. Clinical evidence or suspicion of elevated intracranial pressure.

          4. Preoperative shock or systemic sepsis

          5. Emergency Operation

          6. ASA Class V

          7. Inability of give informed consent

          8. Participation in another clinical trial

          9. Prisoner
No condition on gender to be admitted to the trial.
Accepts Healthy Volunteers
Subject must be at least 19 Years old.
Subject must be at most 100 Years

Eligibility (NLI label): Contradiction