A 70-year-old man with ischaemic heart disease and cardiomyopathy collapsed at work after experiencing dizziness, striking his head on a brick wall. He died from severe head injury and brain swelling. The coroner found atherosclerotic coronary vascular disease was a significant contributing factor, precipitating cardiac symptoms that caused the collapse. No workplace hazards were involved. The clinical lesson is that patients with cardiac disease experiencing dizziness require prompt assessment for cardiac causes, and awareness that syncope from cardiac arrhythmia or hypotension can occur suddenly in workers at heights or near hard surfaces, with catastrophic consequences from head trauma.
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emergency medicineneurosurgerycardiologygeneral practice
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