Patient Case Presentation

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D.B. is a 72 year old African American female who presented to the ED with complaints of headache, altered mental status as evidenced by confusion and lethargy, slurred speech, right sided weakness, and a facial droop. Symptoms were first noted when patient woke up from a nap approximately one hour ago. Patient’s daughter is at bedside. Vital signs on arrival: HR 92 irregular, RR 12, BP 172/91, Temp 99.3, blood glucose 163.

Past Medical History

  • Hypertension-diagnosed at 50 years old
  • Diabetes Mellitus, Type II-diagnosed at 50 years old
  • Hypercholesterolemia- diagnosed at 60 years old
  • Chronic A-fib- diagnosed last year
  • Obesity
  • Depression
  • Sleep apnea, non-compliant with CPAP
  • Frequent falls
  • TIA-approximately 2 months ago

Surgical History

  • Total hysterectomy, 58 years old

Pertinent Family History

  • Mother, deceased at 75 years old- CVA, heart disease
  • Father, deceased at 62 years old- diabetes, heart disease
  • Brother- HTN
  • Sister, deceased at 68 years old- heart disease

Pertinent Social History

  • Smoker, 1-2 packs per day for approximately 50 years
  • Sedentary lifestyle
  • Poor diet, high in sodium