Question

What is the most likely diagnosis for an 80-year-old nursing home resident with a past medical history of mild Alzheimer's disease, hypertension, and reflux esophagitis, who complains of feeling dizzy and a sensation of being about to pass out on the dining table after eating his breakfast? He had similar episodes in the past after finishing his meals. He denies any chest pain or shortness of breath. On examination, he is alert, awake, and oriented to person and place. Vital signs show a heart rate of 74 per minute and blood pressure of 110/70. His vital signs in the morning at 7 am were a heart rate of 70 per minute and blood pressure of 130/80. Other system examination was unremarkable. No recent medication changes were made.

1) Cerebrovascular stroke
2) Recurrent vestibulopathy
3) Postprandial hypotension
4) Benign paroxysmal positional vertigo

Answer 1

The most likely diagnosis for an 80-year-old nursing home resident with a history of mild Alzheimer's disease, hypertension, and reflux esophagitis, who feels dizzy and about to pass out after eating, is postprandial hypotension.

Step-by-step explanation:

The most likely diagnosis for an 80-year-old nursing home resident with a past medical history of mild Alzheimer's disease, hypertension, and reflux esophagitis, who complains of feeling dizzy and a sensation of being about to pass out on the dining table after eating his breakfast is postprandial hypotension. Postprandial hypotension is a drop in blood pressure that occurs after eating. In this case, the symptoms described are consistent with postprandial hypotension, as the episodes occur after finishing meals.