Diagnostic Problem

Abstract

Subject:A.F., widowed, female, aged 67.

Complaint: Blackouts, dizziness, anorexia.

History: This patient had a four year history of extensive investigation and treatment for essential hypertension. She was noted on both in and out-patient interviews to be a very nervous and anxious woman, and her blood-pressure was extremely labile. There was no doubt that the diagnosis of idiopathic hypertension was established, but treatment was unrewarding as the patient lived alone and was never able to fully understand her quite complicated drug regimes. She had been a widow for 30 years and had only one child — a married daughter, with whom she came to live because of her increasing lack of confidence on her own and the failure of therapy to control her symptoms. The “blackouts” were infrequent, but frightening, in that they involved transient partial loss of consciousness, often in crowded places. The dizziness consisted of an unspecific feeling of faintness (not vertigo). The persistent anorexia was the symptom which most troubled the patient and her relatives.