Although it seems likely that Isa’s ischaemic stroke is due to embolism from her atrial fibrillation she has mild anaemia and a raised erythrocyte sedimentation rate (ESR) which raises the possibility of rarer causes such as:
- Giant cell arteritis
- Bacterial endocarditis
- Atrial myxoma
See Topic Loops below for further information on these.
Ruling out the rarer causes of stroke:
- Dr McGregor establishes that Isa has no other symptoms or signs to suggest giant cell arteritis.
- An echocardiogram shows an enlarged left atrium but no evidence of infective endocarditis or atrial myxoma.
- Isa has a low folate which probably explains her mild anaemia with a raised mean cell volume (MCV).
- A mid stream urine specimen confirms she has a urinary tract infection which explains her high ESR which subsequently falls after treatment with trimethoprim.
Topic Loops:
Page last reviewed: 07 Feb 2021
