An elderly man who suddenly lost consciousness

doi:10.1136/bmj.a3009

Published 7 January 2009, doi:10.1136/bmj.a3009
Cite this as: BMJ 2009;338:a3009

Endgames

Case report

An elderly man who suddenly lost consciousness

Radhakrishnan Ramaraj, resident physician

¹ Department of Internal Medicine, University of Arizona College of Medicine, 1501, N Campbell Avenue, Tucson, AZ 85724, USA

drkutty2@gmail.com

The first 150 words of the full text of this article appear below.

While walking on the beach, a 76 year old man lost consciousnesssuddenly and woke up to find his family looking over him. Hehad no convulsions, tongue biting, or urinary or faecal incontinence.He did not recall the event, but his daughter reported thathe fell over without warning.

He had no history of losses of consciousness, but he did admitto occasional chest pain and breathlessness on exertion. Hetook no regular drugs.

Electrocardiography showed sinus rhythm with no ST/T changes.His pulse rate was regular at 68 beats/min, and his blood pressurewas 132/76 mm Hg. Pulses were equal in all four extremities,and pedal oedema was not present. His venous pressure was notraised. On auscultation, his lungs were clear. He had delayedand subdued carotid upstrokes with a loud, late peaking, systoliccrescendo-decrescendo murmur over the sternal border near thesecond intercostal space. The second . . . [Full text of this article]

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