Collapse

In this podcast we discuss the case of: 66 year old gentleman was out having dinner with his family. He describes the pub as very hot, half way through eating his main course, he became very hot and a sweaty and then everything went blank. When he woke, his family were all gathered round him, fanning him. He had not bitten his oral mucosa and had not been incontinent. He felt a bit out of sorts, but knew where he was. An ambulance was called and he was brought to hospital. His wife attended hospital with him, and reports that half way through the meal, he became very quiet and visibly sweaty and fell unconscious for approximately one minute. She reports he was breathing throughout. When he came round, he was a little ‘dazed’ but quickly recovered. The family were a bit concerned because when he was unconscious he had some twitching of his arms and legs. The patient reported no preceding chest pain, palpitations, shortness of breath, he felt suddenly lightheaded just before he collapsed. No head injury. He has never lost consciousness before. Past medical history: Hypertension, osteoarthritis, hiatus hernia Drug history: Ramipril, amlodipine, paracetamol, lansoprazole, NKDA Social History:, Retired caretaker, lives with wife, independent, never smoked, alcohol 2 pints three days a week Examination Appears well Talking in full sentences, not confused RR 16, SpO2 98% on air, chest clear HR 86 reg, lying BP 133/59, standing 136/62, HS I+II +0 ECG – normal sinus rhythm GCS 15/15 Cranial nerves in tact Normal neuro exam   Have a listen to the podcast for the differential diagnoses and to find out what happened. Music by BenSound.