Syncope and Atypical Chest Pain in an Intercollegiate Wrestler: A Case Report

Objective: To present the case of a 20-year-old collegiate wrestler who suffered from atypical chest pains and syncope after rigorous exercise, dehydration, and ingestion of a metabolic stimulant. Background: As a result of pressure to obtain a lower body weight for competition, wrestlers often pursue practices to lose a substantial amount of weight in a short period of time. These practices include rigorous exercise, starvation, dehydration, laxatives, diuretics, and over-the-counter stimulants. Our case involves an athlete who ingested a metabolic stimulant containing ma huang (ephedrine) and suffered from syncope and atypical chest pains during a bout of rigorous exercise and dehydration to lose weight for competition. Differential Diagnosis: Hypertrophic cardiomyopathy, electrolyte imbalance, drug overdose, traumatic head injury, myocardial infarction, syncope. Treatment: The emergency medical services transported the athlete to the emergency room, and he was hospitalized for 2 days. After discharge, the team physician counseled the athlete in the dangers of metabolic stimulants and excessive weight-loss techniques. Uniqueness: This case is unique because it presents an athlete who ingested an over-the-counter stimulant to lose weight and suffered from syncope and atypical chest pains during a bout of rigorous exercise and dehydration. Conclusions: Athletic trainers must understand not only the dangers of excessive weight loss, but also the dangers of using unregulated ephedrine-containing stimulants to aid in weight loss.