Question

A 77-year-old patient presents with light-headedness, fatigue, jugular venous distention (JVD), peripheral edema, atrial fibrillation (Afib), systolic murmur at the left lower sternal border (LLSB) without radiation, heart rate of 64, hypertension (HTN), and hypothyroidism. What is the next best step to determine the cause of light-headedness?

Answer 1

To determine the cause of light-headedness in a 77-year-old patient with multiple cardiovascular symptoms including Afib and JVD, a comprehensive cardiac evaluation including echocardiography and cardiac enzyme studies should be conducted.

Step-by-step explanation:

The next best step to determine the cause of light-headedness in a 77-year-old patient with the described symptoms would involve a thorough cardiovascular assessment. Given the presence of atrial fibrillation (Afib), jugular venous distention (JVD), peripheral edema, and a systolic murmur, it is critical to evaluate the patient for possible heart failure or cardiac ischemia, which could contribute to systemic hypoperfusion and resulting symptoms. Diagnostic tests like echocardiography, cardiac enzyme studies, and likely a carotid Doppler study should be considered to assess the structural and functional status of the heart, as well as to rule out other possible causes of the symptoms such as carotid artery disease.