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Clinical Problem-SolvingFree Preview

The After-Dinner Dip

List of authors.
  • Gertrud L.G. Haverkamp, M.D., Ph.D.,
  • Richard G. Ijzerman, M.D., Ph.D.,
  • Jos Kooter, M.D.,
  • and Yvonne H.M. Krul-Poel, M.D., Ph.D.

An 85-year-old woman was brought to the emergency department by emergency medical services after losing consciousness. The loss of consciousness occurred approximately 45 minutes after the patient finished eating dinner and was preceded by a sudden onset of sweating, palpitations, and a cold feeling. She had had similar but milder symptoms three times in the 2 weeks before presentation.

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Funding and Disclosures

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

Author Affiliations

From the Department of Internal Medicine and Endocrinology, Amsterdam University Medical Center, Amsterdam.

Dr. Haverkamp can be contacted at or at the Department of Internal Medicine and Endocrinology, Amsterdam University Medical Center, Location VUMC, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.

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