This is Part 1 of a four-part Patient Case Quiz.
Click to access: Part 1 | Part 2 | Part 3 | Part 4
Mr. C is an 85-year-old male referred in 2017 for a second opinion with cardiology for episodic "whiteouts."
For further review of individual medications and original case: [Original patient scenario here]
Case Question #1: What could be next steps?
Show Answer
The correct answer is: 4. Need more geriatric condition specific information.
Geriatric-sensitive cardiologists and geriatricians would most certainly recommend gathering more geriatric specific information. These geriatric specific domains are illustrated by Gorodeski, Goyal et al.1 and include:
Figure 1
The data specifically for Mr. C is as follows:
Medical Domain: has been shown in the original case scenario.
Mobility/Physical Domain: He is able to rise from a chair quickly. He walks daily for 1-2 miles when he feels well. He needs assistance with some of his instrumental activities of daily living with preserved activities of daily living.
Social Domain: A very supportive wife who helps with medical care. He is engaged with his children and grandchildren often and has a good social circle aside from family.
Overarching Goals of Care: To not have any further "whiteouts" and to spend 3-months at his summer home, elevation of 4000-5000 feet above sea level.
References
Gorodeski EZ, Goyal P, Hummel SL, et al. Domain management approach to heart failure in the geriatric patient: present and future. J Am Coll Cardiol 2018;71:1921-36.
This was Part 1 of a four-part Patient Case Quiz.
Click to access: Part 1 | Part 2 | Part 3 | Part 4