5th November 2021

A 77-year-old lady with a history of atherosclerotic heart disease presents to her GP having had a fall

A 77-year-old lady with a history of atherosclerotic heart disease presents to her GP having had a fall. The event was witnessed by one of the carers looking after her at the nursing home. The carer states she lost consciousness very briefly. Before the fall, the carer noticed that the patient went very pale and clammy. There was no seizure-like activity during the attack and the attack was not related to a change in posture. The GP carries out a lying and standing BP and an ECG which reveals intermittent complete heart block. What feature within the history differentiates a Stokes Adams Attack from orthostatic hypotension?

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