An 84-year-old patient becomes dyspneic, feels faint, and develops blurred vision when going from sitting...

The correct answer is A. Atherosclerosis.

This patient is experiencing orthostatic symptoms:

Dyspnea

Lightheadedness (feels faint)

Blurred vision

Symptoms triggered by standing and relieved with rest

These findings strongly suggest impaired cerebral perfusion during position change, commonly seen in elderly patients with atherosclerosis.

Why A is correct (Atherosclerosis):

Atherosclerosis leads to:

Narrowed and stiffened arteries

Reduced ability to adjust to positional changes

Decreased cerebral blood flow when standing

NREMT-based medical guidance emphasizes:

“Elderly patients commonly experience perfusion changes due to vascular stiffness.”

“Reduced cerebral perfusion may cause dizziness and visual disturbances with position changes.”

Why the other options are incorrect:

B. Cardiac arrhythmia: Typically causes irregular pulse and symptoms not specifically tied to positional changes.

C. Transient ischemic attack (TIA): Produces focal neurologic deficits (e.g., unilateral weakness, speech difficulty), not just position-related symptoms.

D. Dissecting aortic aneurysm: Presents with severe, tearing chest/back pain and hemodynamic instability, not transient positional symptoms.

Exact Extracts:

“Reduced cerebral perfusion can cause dizziness and syncope, especially in older adults.”

“Atherosclerosis decreases vascular elasticity and affects blood flow regulation.”

“Orthostatic symptoms are common in elderly patients with vascular disease.”