Episode of unconsciousness

Chief Complaint A 71 y/o male presented with unconsciousness. He is having episodes of dizziness for the past 3-4 months. Last month he has 2 episodes of unconsciousness and recovered in about 10 minutes. History He has h/o diabetes and benign prostatic hypertrophy and is on medication for the same. Vitals BP 100/70 mmHg. Pulse: 40/min, Respiratory rate: 17 bpm Investigations ECG and chest x-ray is normal. What next investigation should be done? Treatment Advise the treatment plan

3 Likes

LikeAnswersShare

DD for LOC in this patient 1) Since he is having dizziness for the past few months, consider VBI .More likely because patient is a diabetic. Carotid and vertebral artery doppler study can be done. 2) Seizure disorder , due to cerebral ischemia ,due to DM . MRI, and EEG can give a clue. 3) Hypoglycemic episodes 4) Heart rate is reported as 40 / mnt. Need to rule out Stokes Adam's attack. Needs cardiac evaluation.

Thank you,Doctor
0

? CVA Needs further investigation and evaluation to conclude till reports complied. CT scan angiography. Treatment of unconscious. Inj mannitol Inj dexona Iv NS and correct electrolytes imbalance. Inj ceftam 500mg iv bd. O2 ,ryles tubr catheterization etc. Regular monitoring and constant evaluation required. Maintain IO Chart. Control bSL.

Thanks Dr Dinesh Gupta
0

Evaluate for sick sinus syndrome, hypothyroidism, or heart block, beta blockers etc for bradycardia. MRI brain, carotid Doppler study , Echo CD to see for LV clot. Cardiologist's opinion sos PPI.

His Pulse rate of 40 / minute is the cause of his TIA and stoke - Adams attacks. He needs a cardiac evaluation- by ECG, 2D - Echocardiography, Holter monitoring. Considering a pulse rate of 40 / minute- his only treatment is a Permanent Pacemaker- provided - there are no - contraindications

? TIA .. ? STROKE ADAM'S ATTACKS.. ? HYPOGLYCEMIC .. NEED'S.. CT SCAN .. MRI ..BRAIN.. ECG..2D ECHO STUDY.. ANGIOGRAPHY..

POSSIBLY SICK SINUS SYNDROME.. RULE. OUT THYROID. DISORDERS NEEDS. FURTHER. EVALUATION

Thyroid function tests. Stop beta blocker if any. S electrolytes

UNCONCIOUSNESS it can be diagnosed as yoshapasmara jatamansi kwath 20 ml bd smrati sagar rasa250 mg bd saraswatarishta 20 ml anu tail nasya 6-6 drops

MRI OF THE BRAIN, ELECTROLYTE AND CBC

As per exam his pulse is 40 beats per mt.Please put up his ECG. He could be getting stokes Adams attacks He will need 24 hr.Holter monitoring

Load more answers