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Guidance on Cerebrovascular accident - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Stroke
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
User :   Good Morning, I have a person who carries a cardiac history and complained of numbness on the left side of his body. I rushed him to the nearest hospital where he was diagnosed for his pulse rate, reflexes, vision, ECG... and was declared normal. Additionally, the On-duty doctor in the emergency ward suspected a CerebraVascular Accident, causing loss of blood circulation.
Question: I need more information on CVA and what next steps do you recommend
Doctor :   hi
Doctor :   Dr. XXXXXXXX here. Let me read what you have typed
User :   thank you
Doctor :   CerebraVascular Accident can happen in anyone anytime.
Doctor :   the usuall causes are any embolism or high blood pressure
Doctor :   if the effects are short in duration it is also called as TIA (transient ischemic attack) in some
User :   thank you, what is the cure to CVA?
Doctor :   the underlying cause should be identified and treated/kept under control
Doctor :   what cardiac history does that person ahve?
Doctor :   does he also have high BP, sugar or cholesterol problem?
User :   he has undergone a by-pass surgery. Hope I am using the right terms
Doctor :   ok
Doctor :   when was this done?
Doctor :   are you there?
Doctor :   I have to close the window as you are not responding. Please chat with our doctors 24/7 for medical queries.
Doctor :   hi are you back?
User :   apologies, I was distracted by my kid
User :   yes, I am back
User :   in the meanwhile, I managed to grab the ECG report
Doctor :   its fine, shall we continue with the discussion?
User :   yes please
Doctor :   when was his by-pass surgery done?
User :   2001
Doctor :   does he also have high BP, sugar or cholesterol problem?
User :   sugar is normal
User :   BP is normal
User :   recent read out 170
Doctor :   when was his last visit to his cardiologist?
User :   I need to find out
Doctor :   170 reading was for BP or sugar?
User :   few seconds, I will be back
User :   170 for BP
Doctor :   ok. 170 is elevated reading for BP
User :   visit to cardio was in March 2010. Also, would you like me share the ECG report observations
User :   ECG Iterpretation dt: 04 June 2010 Sinus Rythm with occasional premature ventricular complexes Possible Left atrial enlargement Right bundle branch block, plus right ventricular hypertrophy Septal Infarct , age undetermined Lateral infarct, age undetermined
Doctor :   ok, the infarcts seem to be little worrysome
Doctor :   did his cardiologist see this ECG report?
Doctor :   and ECHO will be needed for him to see if there are any deposits on the septum infarcts
User :   thank you, I lost connectivity
User :   I am back
Doctor :   ok. please proceed
User :   what is an ECHO?
User :   what should be the mormal reading for BP?
Doctor :   it is similar to ultrasound scan
User :   Ok, I was advised a CT Scan, is it similar
Doctor :   blood pressure reading should be less th1n 140 systolic and 90 diastolic
Doctor :   CT scan is different from Echocardiogram (ECHO)
User :   Ok, please help me with systolic and diastolic
User :   what do we mean by that?
Doctor :   systolic is the higher reading, BP is measured say for example 120 (systolic/80(diastolic) mmHG.
User :   to summarise, is this a situation of threat and/or medical emergency?
User :   what is your recommendation summary?
Doctor :   as of now it is not an medical emergency, blood pressure readings should be monitored and controlled
Doctor :   further work up to look for any other underlying cause for CVA should done
Doctor :   preventive measures should be followed to ensure further such incidents do not happen
Doctor :   and these include: Doctor :   looking out for high blood pressure, high cholesterol, high sugar levels, and get them under control, quitting of smoking and alcohol if use is there
Doctor :   and use of blood thinners and anti platelet drugs ig cause is due to clots
Doctor :   ECHO for heart to look for any lesions and/or deposits on the infarcts
User :   blood thinners and anti platelet drugs are being consumed as a part of the post operation treatment
Doctor :   carotid artery scan and possible Aspirin use if indicted with the test results.
Doctor :   ok, then that has to be continued, along with monitoring of bleeding parameters, and doses should be adjusted from time to time based on the follow up investigations.
Doctor :   discuss about all these possible reasons with the treating doctor
Doctor :   have you followed what I have said?
User :   yes
Doctor :   is there anything else you would like to ask me?
User :   very helpful
User :   thank you
User :   one last question
Doctor :   ok. please proceed
User :   CVA | what is your recommended next steps do
Doctor :   I have already listed them out in the preventive measures
Doctor :   which include looking out for causes
User :   Ok, thank you... appreciate your time and valuable inputs
Doctor :   to prevent further such attacks
Doctor :   is there anything else you would like to ask me?
Doctor :   thanks for consulting me. bye for now. take care
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