Case 02

Clinical history and examination

Age: 75 years, Male.
Time of presentation: 08.30

History of event

• Symptoms: at breakfast wife noticed left face droop, slurred speech and weak left arm
• Current time interval since last known well: 3 hrs 20 mins (200 mins)

Past medical history

• AF
• Previous minor strokes
• Moderate cognitive deficits

Relevant medications

• Bisoprolol
• Apixaban: last taken that morning

Relevant social history

• Living circumstance: living at home, with wife
• Prior function and care needs: mobile but needs supervision of most daily activities – mRS 3
• Work/hobbies: retired joiner, watches TV, walks the dog

Examination

• Pulse: 80 irreg, BP: 140/80
• Neuro:
  • Handedness: left handed
  • NIHSS:  10
  • Deficits: left face UMN weakness, moderate dysarthria, flaccid left arm with inattention

Investigations requested with non imaging results

• ECG confirmed AF