ALTERED SENSORIUM SECONDARY TO ACUTE INFARCT IN LEFT MCA TERRITORY (LEFT FRONTAL,TEMPORAL,PARIETAL LOBES) WITH RIGHT HEMIPARESIS GENERALISED TONIC CLONIC SEIZURES ASPIRATION PNEUMONIA HEART FAILURE WITH MID RANGE EJECTION FRACTION(EF=49%) WITH ACUTE PULMONARY EDEMA K/C/O HYPERTENSION SINCE 3 YEARS K/C/O CKD K/C/O HYPOTHYROIDISM SINCE 1.5 YEARS K/C/O COPD
Case History and Clinical Findings A 85 YEAR OLD MALE PRESENTED TO CASUALTY IN UNRESPONSIVE STATE AT 10 AM -DIFFICULTY IN WALKING SINCE 3-5 YEARS HOPI:-PATIENT WAS APPRENTLY ASYMPTOMATIC TILL TODAY MORNING AND THE PATIENT HAD AN HISTORY OF FALL AT HOME FROM CHAIR AT 10 AM AND AFTER THAT PATIENT WAS NOT TALKING SINCE THEN AND NO INVOLUNTARY MOVEMENTS. FROTHING FROM MOUTH –NEGATIVE INVOLUNTARY DEFECATION- NEGATIVE ; MICTURITION + ; DEVIATION OF MOUTH TOWARDS LEFT SIDE+ POST-ICTAL CONFUSION+ H/O HEARING LOSS NO H/O SIMILAR COMPLAINTS IN THE PAST. NO H/O FEVER,COLD,COUGH ALLERGIES,ABDOMINAL PAIN,NAUSEA,VOMITING K/C/O HEART FAILURE WITH MID RANGE EJECTION FRACTION(45%)?SECONDARY TO CAD ON T. ECOSPIRIN AV 75/40 OD AT 9PMCARDIVAS 3.125 MG BD NON OLIGURIC AKI ON CKD X 9-10 YEARS ON CONSERVATIVE MANAGEMENT K/C/O HYPERTENSION SINCE 3 YEARS ON TAB. TELMA 20 MG OD K/C/O HYPOTHYROIDISM SINCE 1.5 YEARS ON T. THYRONORM 25MCG OD FAMILY HISTORY:-INSIGNIFICANT PERSONAL HISTORY:- DIET-MIXED SLEEP-ADEQUAT