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Last year, a cardiologist at my institution presented the story of a patient he had cared for and correctly diagnosed with a not uncommon condition after several other physicians had failed to do so. The patient was a 72-year-old man with near syncope after exercise for several months, with no other symptoms or clues to the diagnosis. The cardiologist asked him to discuss each episode in detail, and the man noted that each morning, he walked briskly on his treadmill for 30 minutes, stopped and checked his pulse, and they would experience several minutes of lightheadedness that would dissipate by the time he walked from the basement to the first floor.
Jason Liebowitz, MD, completed his fellowship in rheumatology at Johns Hopkins University, Baltimore, where he also earned his medical degree. He is currently in practice with Skylands Medical Group, N.J.