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Postgraduate Medical Journal 2004;80:679-680
© 2004 Fellowship of Postgraduate Medicine

SELF ASSESSMENT QUESTION

Bradycardia and hypotension

Symptomatic bradycardia and postural hypotension

R Gupta 1, S Singh 2, M A Rahman 1, M Saeed 1, Y Birnbaum 1

1 Division of Cardiology, Department of Medicine, University of Texas Medical Branch at Galveston
2 Department of Internal Medicine, University of Texas Medical Branch at Galveston

Correspondence to:
Correspondence to:
Dr Yochai Birnbaum
Division of Cardiology, University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, Texas 77555, USA; yobirnba@utmb.edu

Submitted 3 December 2003
Accepted 18 December 2003

Answers on 681.

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

A 24 year old white woman presented to hospital with complaints of recurrent dizziness and lightheadedness. She also admitted to several non-exertional episodes of passing out, lasting for a few minutes, over the past two years. These episodes were not associated with seizure-like activity. She had been admitted to multiple hospitals in the past with similar symptoms without any conclusive diagnosis or treatment. Hypertension was diagnosed five years earlier for which she was receiving clonidine and nifedipine. Work-up for secondary hypertension at another hospital, including urinary metanephrines, cosyntropin stimulation test, and a renal arteriogram had all been negative in the past. There was no history of diabetes, prior psychiatric disorder, or family history of sudden death. She had a history of syringomyelia with Arnold-Chiari malformation for which she had received decompression surgery at the age of 12 years.

The patient was found to have a heart rate . . . [Full text of this article]


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