Dizziness, blurred vision, and felt like passing out

1. Near Syncope

2. Diagnosis Dehydration/heat exhaustion

3. Acute renal failure

4. elevated triponin

5. valvular heart disease

6. brain tumor

7. hypomagnesia

8. vindicate

9. Key features age 88, outside in 100 degree weather working in yard for several hours at a time, no adequate hydration

10. near syncope

11. negative key features: resolved renal failure,no shortness of breath, no chest pain

12. vertigo-dizziness caused by underlie disease multiple

13. Differential diagnosis

14. Torsades de points lethal ventriculararrythmia caused by hypomagnesia. Hallmark sign on ekg rotating v-tach

15. possible due to magnesium level 1.7 but not likely magnesium level not critical

16. Non-stemi- ischemia to heart wall due to blockage in vessel or spasm to vessel

17. Heart ischemia can cause near syncope but not likely no elevated CK-MB, TCK, no shortness of breath, no chest pain, negative stress test 1yr prior

18. TIA- transient ischemic attack are brief ischemic attack causing neurologic dysfunction

19. TIA is possible but not likely the weakness and near syncope were to dehydration as demonstrated in elevated creatinine. CT scan ruled out

20. Vertigo is possible with dizziness but has no chronic inner ear problems causing these symptoms

21. Brain tumor reocurrence- can cause multiple symtoms headache, dizziness, near syncope

22. Brain tumor possible but was ruled out with ct scan