CASE REPORT
Ahead of print publication

Recurrent syncope in an 84-year-old man

Correspondence Address:
H Li,
Department of Internal Medicine and Geriatrics, Beijing Friendship Hospital, Capital Medical University, Beijing
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpgm.jpgm_414_22

PMID: 36861546

An 84-year-old man with hypertension and type 2 diabetes presented with recurrent transient loss of consciousness within 2 hours after dinner at home. Physical examination, electrocardiogram, and laboratory studies were unremarkable except hypotension. Blood pressures were measured in different postures and within 2 hours after meal, but neither orthostatic hypotension nor postprandial hypotension was detected. Further, history taking revealed that the patient was tube-fed with a fluid food pump with an inappropriate rapid infusion rate of 1500 mL per minute at home. He was eventually diagnosed as having syncope due to postprandial hypotension, which was caused by the inappropriate way of tube feeding. The family was educated about appropriate way of tube-feeding and the patient did not develop any episode of syncope during a two-year follow-up. This case highlights the importance of careful history taking in the diagnostic evaluation of syncope and the increased risk of syncope due to postprandial hypotension in the elderly.

Keywords: Aged, enteral nutrition, postprandial hypotension, syncope