Physician's Assistant

Sdec Tue 22 July 2025 17:03

Last Modified: 258 days ago

MRN:

Content:

Presenting Complaint:
Collapse in bank

Past Medical History
• Hypertension - on Amlodipine 5mg OD
• Kidney impairment (chronic)
• Previous collapse 2 years ago in June at home with head injury
• Memory loss

Diagnosis:
Syncope - cause to be determined

I had the pleasure of meeting Anthony in Same Day Emergency Care today.

Anthony presented following a collapse in the bank this morning at approximately 09:30. He was queuing for about 30 minutes when he felt a little dizzy and then collapsed. He regained consciousness quickly (within seconds to minutes) and was not confused. He had only had coffee and biscuits for breakfast, which is his usual. There was no chest pain, palpitations, or head injury. He denies any recent illness, sore throat, or feeling unwell.

This is not the first episode - he had a similar collapse 2 years ago in June at home which resulted in a head injury. He also reports experiencing dizziness when getting up from lying to sitting position. He has no history of cardiac problems or diabetes.

O/E: Chest examination was normal with clear breath sounds bilaterally. No obvious injuries noted.

Recent blood tests show kidney impairment (chronic, not new) and slightly raised white cell count. Other inflammatory markers not significantly elevated.

Investigations:
Blood tests: Kidney impairment (chronic), slightly raised white cell count, other inflammatory markers normal

Plan:
1. 24-hour Holter monitor (can be fitted as outpatient)
2. CT head
3. Postural blood pressure measurements (lying and standing)
4. Follow-up with results and further management as indicated

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Summary:

Investigations:

Sdec Tue 22 July 2025 17:03

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