Syncope in an 80-yr-old Woman

• General: The patient had been feeling fine at home until today. She felt light-headed in the shower before her episode.


• Skin: She denies any rashes. She has bruising on her abdomen where she received injections for venous thromboembolism prophylaxis during her recent hospitalization. Her right groin incision site has not been painful, red, or purulent.


• HEENT: Noncontributory


• Pulmonary: Dyspnea at rest.


• Cardiovascular: Constant, midsternal chest pain and pressure that does not radiate. No palpitations before or after this morning’s event.


• Gastrointestinal: Noncontributory


• Genitourinary: Noncontributory


• Musculoskeletal: Denies pain in arms or legs.


• Neurologic: Feels light-headed with standing. No vision changes, focal weakness, or other neurologic symptoms.


• Psychiatric: History of mild dementia with intermittent forgetfulness. Her husband states that her dementia did not seem worse before today’s event but she now seems confused.