ABSTRACT
You are reviewing patients in the medical outpatient clinic. Your next patient has been referred by her general practitioner with the following letter. Please read the letter and then review the patient.
Dear Doctor,
Re: Mrs Mary Harbottle
Age: 77 years
I would appreciate your advice on this elderly lady. She has developed dizzy spells on a number of occasions and has only just managed to avoid falling and doing herself serious injury. Clinical examination is unremarkable except for a soft systolic murmur. An ECG shows normal sinus rhythm and blood tests have also proved to be normal. I am at a loss as to where to go from here and hence am turning to your good self for guidance.
Yours sincerely
