Or1535 Non-Specific Dizziness

Carla Costa1, Ana Sofia Alves2 e Bernardo Alves Castro3
1USF S.Nicolau; 2USF S. Nicolau; 3Usf S Nicolau
Introduction: Dizziness is a non-specific term and a frequent complaint in the primary care setting. Its appearance may signalize numerous and distinctive disorders, specifically, psychiatric conditions or organic diseases. Iron-deficiency anaemia is a recognized cause of dizziness and its detection in the woman of childbearing age demands a systematic approach in order to establish its aetiology. The clinical history, the physical examination and the subsequent work-up guide the family practitioner in its investigation.
Objective: We intent to demonstrate that a non-specific complaint may be crucial for the diagnosis and well-timed treatment of an otherwise inevitably fatal disease. Methods: data was gathered from clinical records using the medical record system SAM® .
Results: Woman, 46 years old, Caucasian, seamstress, belonging to an extended family with a personal history of left breast cancer (mastectomy in 2002). In February of 2013, the patient complaints of dizziness/orthostatic hypotension without associated signs or symptoms. In the physical examination, paled mucous membrane was noticed, with normal vital signs and cardiac auscultation, as well as a brief neurological examination. The investigation was commenced. In April of 2013, the presence of an iron-deficiency anaemia was confirmed, with progressive deteriorating values. The later endoscopic study revealed a neoplasm localized in the proximal ascending colon, friable with superficial ulceration, involving ¿ of the lumen’s circumference, without stenosis. In September of 2013 the patient was conducted to hospital care where she was submitted to a right colectomy within 1 month time.
Conclusion: Iron-deficiency anaemia is a frequent, multiple aetiological condition. It may not only reflect a nutritional deficit or menometrorrhagias, but also a presence of an organic disease. We aimed to demonstrate the importance of the aetiological investigation of non-specific signs and symptoms that may, as in this case, reveal a disease that is silent in the majority of the cases due to its localization, until it reaches advanced stages when no longer a curative treatment may be offered. This case also envisioned to demonstrate the importance of the family practitioner in the attempted detection of high morbidity and mortality diseases for which a suitable treatment exists, as well as the unified vision of the primary care setting
Dizziness; iron-deficiency anaemia; colorectal neoplasm