Tuesday, April 26, 2016

Make the Diagnosis: Dizziness Dilemma

(MedPage Today) -- Case Findings: The patient is a 42-year-old African American man who presents with a complaint of dizziness lightheadedness which occurred when he was standing up to go to the rest room 3 days ago. He denies any previous syncopal episodes. He has medically managed hypertension, hypercholesterolemia, cardiomyopathy with last ejection fraction of 35% with defibrillator placement 4 months previous. His ICD did not fire during the episode. His last cardiac catheterization prior to ICD implantation revealed normal coronaries. Patient has been compliant with metoprolol 25 mg twice daily, lisinopril 10 mg daily, atorvastatin 40 mg daily. He denies any new medical regimen. His vital signs are BP 100/80 mm Hg and HR 66/min. His physical examination is normal without any clinical evidence of decompensation. ECG is shown below. What is the next best course of action?
via Make the Diagnosis: Dizziness Dilemma

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