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Congenital Heart Disease and Stroke!

2K views 8 replies 5 participants last post by  K06100 
#1 ·
A 32-year old male is seen in the ED with sudden onset weakness of right upper and lower extremities developing about an hour ago. He has a H/O congenital heart disease since birth and remained asymptomatic up to now. For the past few days, he has been complaining of left lower extremity pain, tenderness and swelling. His vitals are HR-87 beats/min, RR-25 beats/min, temp-98.6 F. While you see him, you notice he is unable to speak. Based upon the scenario, What is the appropriate next step of management ??

A. Give a tablet of Aspirin immediately.
B. Begin intravenous fluids and wait until he speaks.
C. Order echocardiography.
D. Send him for doppler ultrasound and wait for results.
E. Get a non-contrast CT scan immediately.
F. Begin thrombolytic therapy immediately.
G. Begin i.v heparin and then place the patient on warfarin.

plzz explain in detail if possible ......
 
#3 ·
Paradoxical embolism go for thrombolytic therapy.i dont think there is a need fir Ct given the history.
sudden onset weakness is hemorrhagic stroke i think ...bcoz ischemic stroke takes time to evolve ?????

I thought CT scan so as to differentiate b/w ischemic and hemorrhagic stroke......actually i dont have the answer for it..so need a good explanation for this........
 
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