This is to share an experience of diagnosing an interesting clinical case from timely alert from a nursing colleague. A 33-year-old man with a normal built and without any past medical history of major illness was brought to my general practice clinic in a remote village after a fainting episode and vague upper abdominal discomfort. Except for a 15 pack-year history of smoking, he didn't have any health issues. Family history was unremarkable.
Physical examination was normal with a heart rate of 86/minute, blood pressure 124/76 and respiratory rate of 16/ minute. Cardio-respiratory examination and abdominal examination was normal with no neurological signs of note. Because of the unusual presentation, I just planned to observe him for sometime in the clinic asking the nursing colleague to check his vital signs every 10 minutes and continued my consultations for other cases. Within half…
