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Differential diagnosis: Collapse / fall

Neurological

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Other neurological differentials = neuropathy (e.g. MS), intracranial haemorrhages (extradural, subarachnoid, subdural), raised intracranial pressure

Cardiovascular

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Other cardiovascular differentials

  • Structural (e.g. hypertrophic obstructive cardiomyopathy, arrhythmogenic right ventricular dysplasia)
  • Carotid sinus hypersensitivity (precipitated by head turning/shaving – diagnosed by carotid sinus massage** → ≥3 second pauses)
  • Vertebrobasilar insufficiency (vertigo precipitated by head extension in elderly patients with cervical osteoarthritis)
  • Subclavian steal syndrome (proximal subclavian artery stenosis causes retrograde flow in one of the vertebral arteries as they become involved in a collateral circuit to bypass the obstruction)

Other

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Other differentials = postural instability, polypharmacy, ectopic pregnancy, ruptured AAA, delirium, vertigo, anaemia, hypoglycaemia, hypercapnic acidosis, sepsis, eyesight problems, arthritis, leg weakness, anxiety, factitious blackouts, choking, heat syncope, multifactorial

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