An 80-yr-old woman is brought to the emergency department by emergency medical services (EMS) personnel because of a syncopal episode at home. She had been in the shower, suddenly felt weak, and collapsed to the floor. Her husband heard her fall and found her awake, lying on the bathroom floor. He called EMS who, when they arrived in the patient’s home, found her to be tachycardic and hypotensive. On arrival in the emergency department, she is confused and has difficulty answering questions. Her husband states she has hypertension, dyslipidemia, and mild dementia and, 1 wk ago, had a transcatheter aortic valve replacement for severe aortic stenosis. He was told the procedure had been uncomplicated and states that his wife had been feeling well during her recovery. She has never had an event like this one before.
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