Brief Answer:
Needs to see Neurologist, get bloodwork, urinalysis, and MRI of brain

Detailed Answer:

Hi,

Your husband is suffering from these symptoms of confusion and what sounds to be disorientation as well as memory/cognitive compromise. If these symptoms SUDDENLY came on then, one must consider 3 possibilities:

1. If symptoms appeared AFTER his cardiac stent was placed then, there is a good chance he suffered a complication from that procedure which was not recognized at the time he was recovering and was discharged. This happens all too commonly.

2. If these are ACUTE (i.e. just happened within the past 24-48 hrs. then, he may very well have suffered a STROKE in his left cerebral hemisphere which was probably caused by a blood clot (embolic). Alternatively, he could be suffering from a urinary tract or even some other type of infection such as in the middle or inner ear, sinuses, pharyngitis, endocarditis (heart), blood (sepsis), or pneumonia.

3. If these symptoms are chronic (i.e. started some time ago...even before the stent and have been getting progressively worse then, he may have suffered a remote insult to the brain such as a stroke or blood clot that traveled up to the left hemisphere but the area was so small that it took time for the problem to really become apparent or manifest. In addition, he could have some type of metabolic disturbance such as sudden loss of control over his diabetes, kidney function decline which can both cause this sort of delirium to occur if not recognized. Or, there could be specific metabolic and/or nutritional deficits causing these changes such as LOW or DEFICIENT quantities of Vitamin B12, Vitamin D, Vitamin B1 or B2. And there could also be poorly or suboptimally functioning THYROID, ADRENAL, OR TESTOSTERONE hormones in the system which can change system function and consequently behavior and memory.

Which one of the above 3 happened can likely be figured out but he should see a NEUROLOGIST sooner rather than later and preferably one who deals with strokes or a behavioral specialist which means that they'd be looking for other deteriorations in the brain (some of which are reversible if identified as blood deficiencies) such as Alzheimer's disease, Frontotemporal Lobe dementia, or even a small but unrecognized BRAIN BLEED that could've come from a small aneurysm or even parenchymal (brain substance) bleed which could've been as a consequence from having diabetes, hypercholesterolemia, or hypertension (if he has that..which they usually do).

By the way, he should AT THE SAME TIME as everything above return to his cardiologist to make sure he hasn't suddenly developed a cardiac problem as well such as ATRIAL FIBRILLATION or some other heart condition that could be resulting in poor blood pumping action to the brain which can then, look very similar to a stroke. For that sort of evaluation, he will need an EKG and ECHOCARDIOGRAM in order to determine things such as rhythm characteristics and EJECTION FRACTION of blood from the heart.

Hope you found the answer helpful.

Regards,
Dr. Dariush Saghafi, Neurologist

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