The correct answer is A. Atherosclerosis.
This patient is experiencing positional (orthostatic) symptoms, including:
Dizziness / feeling faint
Blurred vision
Symptoms that occur when standing and resolve at rest
In elderly patients, this pattern strongly suggests reduced cerebral perfusion upon standing, often due to vascular insufficiency from atherosclerosis.
Key reasoning:
Atherosclerosis causes narrowing and stiffening of arteries.
This limits the body’s ability to quickly adjust blood flow during position changes.
As a result, transient cerebral hypoperfusion occurs when standing, causing the described symptoms.
Why A is correct:
It best explains age-related vascular insufficiency and positional symptoms.
The patient’s elevated blood pressure also supports chronic vascular disease.
Why the other options are incorrect:
B. Cardiac arrhythmia: Typically causes sudden, unpredictable symptoms, not consistently position-related.
C. Transient ischemic attack (TIA): Causes focal neurological deficits, not just positional dizziness that resolves with rest.
D. Dissecting aortic aneurysm: Presents with severe, tearing chest or back pain, not positional lightheadedness.
Exact Extract (EMT-aligned educational content):
Elderly patients commonly experience dizziness or syncope due to decreased cerebral perfusion.
Atherosclerosis reduces vascular elasticity and blood flow, impairing the body’s ability to compensate for position changes.
Symptoms such as lightheadedness and blurred vision upon standing indicate transient cerebral hypoperfusion.
[References:, NREMT National EMS Education Standards – Cardiovascular Emergencies , EMT Training Curriculum – Syncope and Cerebral Perfusion , National EMS Scope of Practice Model – Patient Assessment and Perfusion Disorders , ============================================================, ]
