GP emergency management

A woman with ventricular thrombotic emboli

Vivienne Miller



Kim is 73 years old and is well known to you at your practice. She has well-controlled hypertension, normal glucose tolerance, normal results on lipid studies and no other major medical problems. She takes enalapril 5mg daily. She comes to see you because she has been feeling ‘dizzy’ for the past two days.

Key Points

  • All acute neurological deficits must be taken seriously and patients educated to seek urgent medical advice for them.
  • If the patient is not hospitalised, urgent investigation, referral and treatment need to be arranged.
  • Transient ischaemic attacks in particular are often inadequately investigated, as their transient nature means patients may not realise their significance.
  • Cardiovascular causes should be considered and investigated in all patients with acute neurological deficits of unknown cause.