Description
In this case presentation, we explore a compelling instance of stroke, a medical emergency that demands swift intervention. Delving into the patient's history, symptoms, and diagnostic findings, we aim to unravel the intricacies of this cerebrovascular event. By examining the nuanced aspects of the case, we hope to shed light on the challenges encountered in stroke management, emphasizing the significance of early detection and comprehensive care in mitigating its potentially devastating effects.
Summary Listen
- Dr. Rea hosted an Assimilate session focused on cardioembolic stroke, featuring Dr. Misha, an emergency medicine physician, who presented a case. The aim was to unravel the case and its learnings for healthcare professionals. Dr. Misha explained his selection of cardioembolic stroke due to the rising prevalence of comorbidities in younger individuals, necessitating early diagnosis and treatment for improved patient outcomes.
- The case presented involved a 69-year-old female with type 2 diabetes, hypertension, ischemic heart disease, recent angioplasty, and chronic atrial fibrillation. She presented with left-sided hemiparesis, bilateral limit ataxia, and right-sided facial deviation. Despite being on apixaban, a factor Xa inhibitor, she still experienced a stroke.
- Initial assessments ruled out certain conditions like posterior circulation issues, increased intracranial pressure, and mitral valve issues. Imaging studies revealed a non-hemorrhagic infarct in the right Corona radiata and complete occlusion of the internal carotid artery. 2D echo showed a clot in the left atrium, confirming a cardioembolic origin.
- The patient was within the thrombolysis window, but the presence of apixaban and an INR of 1.9 contraindicated thrombolysis due to bleeding risk. Mechanical thrombectomy was performed instead, leading to significant improvement in the patient's NIHSS score. Key factors for successful management included rapid symptom recognition, early hospital presentation, and minimizing door-to-imaging time.
- Dr. Misha also discussed stroke mimics and emphasized lifestyle modifications such as healthy eating, regular exercise, and sufficient sleep for stroke prevention. He noted that vaping among teenagers poses a greater risk for stroke than smoking. He reinforced the importance of early diagnosis, prevention through regular check-ups, and maintaining a healthy lifestyle as essential takeaways.
Sample Certificate
About the Speakers
Dr. Mihir Shah
Emergency Medicine Physician And Diabetes Care, Wockhardt Hospital, Mumbai
Financial Disclosure
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