ABSTRACT
This chapter presents a case study of a 82-year-old woman who is brought to the Emergency Department after fainting in her home. She has a history of ischaemic cardiomyopathy, having undergone a triple-vessel CABG more than 10 years ago. Her medications include bisoprolol, amlodipine and lisinopril. The history provided in this case fits well with syncope, which refers to transient and self-resolving loss of consciousness that arises as a result of reduced cerebral perfusion. Management of this patient should proceed along the Advanced Life Support (ALS) bradycardia algorithm. She should be placed on a cardiac monitor in the resuscitation room and blood should be drawn to check for electrolytes, as severe metabolic disturbance can lead to bradycardia. Observation would only be appropriate if she did not present with high-risk features and her rhythm was not one associated with a high risk for asystole.
