3. Clinical presentation
A 65-year-old man complaints of transient loss of consciousness and vision
in his right eye. He had two episodes in the previous month, each lasting for
approximately 7-10 minutes. Two months ago, he also had transient slurring
of his speech.
Social history: he is chronic smoker, over weight and has sedentary life style
5. Systemic Examination
Cardiovascular system: Displaced apex beat and ejection systolic murmur.
Carotid bruits audible.
No peripheral pulses palpable below the femoral arteries
RES, GIT and CNS: Unremarkable
Provisional diagnosis: Cerebral Transient Ischemic attacks, Stroke, side
effects of some drugs, hypoglycemia
6. Investigations
Blood sugar: within normal limits
Blood test: serial cardiac enzymes normal
Chest X-ray: showed cardiomegaly with evidence of pulmonary edema
ECG: shows atrial fibrillation and old anterior myocardial infarct
Echocardiogram: shows thrombus within the left atrium
Carotid Doppler studies: indicated moderate carotid artery stenosis
7. Diagnosis: Stroke (Cerebrovascular accident-CVA)
Management:
He was given antihypertensive drugs to control his blood pressure
Anticoagulant started to reduce the risk of such future attacks
Recommended regular follow up
8. Student Activity for Home
SAQs and SEQs
Q1. What are the causes of vascular occlusion?
Q2. What are the predisposing factors of vascular occlusion?
Q3. What predisposing factors of vascular occlusion are present in this
case?
Q5. What is the cause of vascular occlusion in this case?
Q6. What are the effects of vascular occlusion?
Q7. What are the predisposing factors of vascular occlusion?
Q8. What predisposing factors are present in this case?
Q9. What is thrombus and its composition?
Q10. Describe thromboembolic phenomena and mention complications.
