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Washington University Experience | VASCULAR | Small Vessel Disease | 6A0 Case 6 History
Case 6 History ---- The patient was a 45 year-old man with a history of Type 2 diabetes, hepatitis C, hypertension, cerebrovascular accident, polysubstance abuse (cocaine, heroin, marijuana), gunshot wound x 2, chronic kidney disease, and diastolic cardiac dysfunction. He was admitted to BJH on February 1st of 2011 after being found agitated and confused. Initial labs included: BP=255/142 mmHg, Glucose=653 mg/dL, HgbA1C=11.5%, BUN=31 mg/dL, Cre=3.64 mg/dL, Urine drug screen was positive for cocaine metabolites. Head CT showed cerebral atrophy, chronic small vessel ischemic changes with multiple unchanged lacunar infarcts involving the right centrum semiovale and right thalamus; however, no acute intracranial pathology was seen. His hospital course was stormy with sepsis, hypotension, thrombocytopenia and terminal cardiac arrhythmia. ---- General autopsy findings showed bronchopneumonia, sepsis and cardiac hypertrophy (530 grams) with increased thickness of the left ventricle wall.
