• Heart Failure
  • Cardiovascular Clinical Consult
  • Adult Immunization
  • Hepatic Disease
  • Rare Disorders
  • Pediatric Immunization
  • Implementing The Topcon Ocular Telehealth Platform
  • Weight Management
  • Monkeypox
  • Guidelines
  • Men's Health
  • Psychiatry
  • Allergy
  • Nutrition
  • Women's Health
  • Cardiology
  • Substance Use
  • Pediatrics
  • Kidney Disease
  • Genetics
  • Complimentary & Alternative Medicine
  • Dermatology
  • Endocrinology
  • Oral Medicine
  • Otorhinolaryngologic Diseases
  • Pain
  • Gastrointestinal Disorders
  • Geriatrics
  • Infection
  • Musculoskeletal Disorders
  • Obesity
  • Rheumatology
  • Technology
  • Cancer
  • Nephrology
  • Anemia
  • Neurology
  • Pulmonology

Seen in the ED: An Elderly Man Feels Dizzy Doing Dishes


History of present illness. An elderly man was washing dishes when he became very dizzy and almost fainted. He was a poor historian and there was a language barrier requiring an interpreter, but he seemed to endorse symptoms of both vertigo and near-syncope as well as "a funny feeling in his chest" during the episode, which lasted about 5-10 minutes. He denies pain, fever, cough, headache, or other symptoms and feels fine now.

Vital signs & physical examination. Vital signs were normal although the systolic BP was significantly different—by >20 mm Hg—between arms. The rest of the physical exam, including the HINTS exam, Romberg, gait, and orthostatic measures were all normal.

Initial Diagnostic Testing

  • CBC: normal
  • Chem-7: normal
  • Troponin & ECG: normal
  • Imaging: see CT chest below

What is the most likely diagnosis?

Related Videos
Primary Care is the Answer to the Migraine Care Gap, Says Headache Specialist
Migraine Management Pearls for Primary Care with Neurologist Jessica Ailani, MD
Migraine-specific therapies belong in primary care setting, Jessica Ailani, MD
Related Content
© 2024 MJH Life Sciences

All rights reserved.