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Tue Feb 13 20:13:18 GMT 2007

In a message dated 2/13/2007 1:38:56 PM Central Standard Time,  
ecthompson at msn.com writes:

The  daughter mentions that the patient slept soundly all night.   
Unfortunately, the patient was unarousalable following morning.  A stat  CT of the head 
revealed several areas of infarct.  These areas were not  confined to a 
specific distribution.  Comfort measures were  ordered.

where is she showering microemboli from? Any otherwise occult history of  
Afib that might have had a little clot in the left atrium that broke up? or an  
ulcerating lesion in one of the carotids? I'm not seeing anything to make  me 
think that she'd have something that would make it through the lungs from the  
systemic circulation at this point.

While it may be a moot point right now, I'd be looking for an  echocardiogram 
and a duplex carotid Doppler as noninvasive, non dye load  tests.

ck
Charles S. Krin, DO FAAFP

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