Heres a scenario,
46 year old lady. Previous MI 11 years ago but normally 'well'.
Found by partner at home with signs of Left hemisphere (MCA) cva. brought to
A&E. initially quite slurred and unintelligible. In AF which is new for her.
CXR shows big heart, I presume 2ry to Ischaemic cardiomyopathy from old infarct.
Within an hour of arrival complete resolution of symptoms. Whilst waiting for
the bed to appear on MAU (!surely not!) Recurrence of left sided symptoms.
What would you do?
I phoned the Med SHO and said things like '?? early CT ?? possible thrombolysis??'.
SHO said '!!!!!!!!!! ermm speak to my reg' who said 'No No! No! only Newcastle
does that in UK. No role for it etc etc'
Is Newcastle the only place to do it?
Is this a suitable patient?
what else could we as ED drs be doing for this lass?
Any thoughts?
Cheers
Peter A Cutting
SpR Emergency Medicine
Royal Preston Hospital
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