ABSTRACT
A 77-year-old man was brought to hospital after collapsing on the bus. He reported standing up when the bus reached his stop and suddenly finding himself lying on the floor. He described feeling light-headed and as though his vision were ‘blacking out’ in the seconds preceding his collapse. Eye witnesses reported that he lost consciousness for several seconds and subsequently awoke and was fully orientated. There was no tongue biting, jerking of limbs or incontinence. The patient denied experiencing any chest pain, shortness of breath or palpitations prior to the collapse. He had experienced several similar episodes of collapse after standing recently. The patient’s past medical history included benign prostatic hyperplasia, ischaemic heart disease and type 2 diabetes mellitus. His regular medications are listed below. The patient owned and worked on a local market stall every day selling fruit and vegetables. He did not drink alcohol and was a current smoker of 20 cigarettes daily, with a 50-pack year history.
