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Washington University Experience | VASCULAR | Infarct - Remote | 5A0 Case 5 History
Case 5 History ---- The patient was a 65 year old man with a past medical history of two cerebrovascular accidents in 1973 and 1976 (16 & 19 years before his death), an enlarged heart, chronic hypertension, increased cholesterol, and a probable seizure disorder. His final presentation to BJH occurred after ten days of rhinorrhea, malaise, cough with clear sputum, nausea, and emesis. He had also noticed lower extremity edema, dyspnea on exertion, fatigue, and tachypnea at rest. He denied chest pain and had no previously documented myocardial infarcts. His initial cardiac enzymes were negative at this hospitalization. The patient's hospital course was complicated by hypotension and continuing shortness of breath. On the third hospital day the patient developed respiratory distress, was intubated and moved to the coronary care unit. A ventriculogram showed a left ventricular ejection fraction of 28% with hypokinesis. On his fifth hospital day, the patient's MB fraction tests returned positive. The patient experienced a cardiac arrest on his ninth hospital day and could not be resuscitated.
