I can’t stand being dizzy

Author: Jithin Thomas / Editor: Nick Tilbury / Codes: / Published: 16/02/2023

A 71-year-old female presents to the emergency department (ED) with intermittent dizzy episodes over the previous 2 years. She has a background of hypertension and paroxysmal atrial fibrillation.

The patient tells you that she has also been feeling very tired and run down over the past year and has been investigated by cardiology for these symptoms, but no cause has been identified.

Her regular medication includes Bisoprolol 1.25mg, amlodipine 5mg and Apixaban 5mg.

Physical examination is normal, and observations are as below:

  • BP: Lying 168/90 mm/hg. Standing 130/80 mm/hg
  • Pulse: 80 bpm
  • Respiration rate: 16
  • Oxygen saturation: 98%
  • Temperature: 37.1

Bloods shows a sodium of 127mmol/l and a potassium of 5.9mmol/l but are otherwise normal.

ECG shows normal sinus rhythm.

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