Here is my grandfather’s case
Doctor Consultant Report
Summary:
Age: 83y
Sex: M
walk with stick ,ex-smoker ,non drinker, live with family
hoarseness for around 4 months
CXR: aortic aneurysm
ECG: fast AF
sCr 168 on admission
CT brain: chronic ischaemia
imp:
1. HT/CRF/ right renal artery stenosis with fast AF
2. hoarseness? related to aortic aneurysm
consulted ENT L VC palsy
urgent CT thorax with contrast done
Impression
1. 8.0cm aortic arch aneurysm distal to the origin of left subclavian artery. Mixed hyper- and hypo-dense intra-mural density, suspicious of subacute intra-mural hematoma. No CT evidence of dissection or rupture.
2. Atrophic right kidney with narrowed right renal artery, suspicious of right renal artery stenosis
all along no chest pain/back pain
Suggest arrange urgent USG carotid doppler and echo bedside echo today
In AF, normal LV size, dilated LA(4.3cm) and aortic root (~3.7-4cm)
mild to mod AR, mild TR/MR, RVSP 35mmHg
overall impaired LVEF 40%with septal hypokinesia
no pericardial effusion
pending urgent USG carotid Doppler
cont