A 74-year-old lady complains of periods of dizziness with occasional associated blackouts. She is on no regular medicines

b. An ECG is the most sensible place to start in investigation of this lady’s symptoms. The most likely cause for her symptoms is either sinus pauses or arrhythmias. Should she have been taking vast numbers of medications this would have been a sensible place to start. If an ECG does not yield a diagnosis it may then be sensible to proceed onto a 24-hour tape to hunt for further answers.