Following the diagram below we know that:
- Isa has had an ischaemic stroke which has been confirmed by a CT scan
- Her carotid duplex showed no stenosis
- No rare causes were identified
- She has atrial fibrillation and has been initially prescribed antiplatelet drugs (aspirin 300 mg once daily). This will be changed to anticoagulant drugs in due course (normally warfarin would be started 14 days post event). See Topic Loops below for further information.
- She is prescribed cholesterol reducing drugs (simvastatin 40mg at night)
- Her blood pressure lowering drugs have been adjusted (bendroflumethiazide 2.5mg, ramipril 5mg) and she is prescribed beta blockers to control her heart rate (bisoprolol 2.5mg od)
- Her initial glucose level was raised but no changes have been made to her diabetic medication at this stage
Lifestyle behaviour changes should be used in conjunction with drug therapy to reduce the risk of recurrence
Topic loops:
Stroke → Brain scan → Ischaemic → Identify & treat rare causes
Stroke → Brain scan → Ischaemic → ECG →
Stroke → Brain scan → Ischaemic → Anterior circulation only → Carotid imaging → No stenosis → ECG →
→ ECG → Atrial fibrillation → If risk of bleeding too high → Antiplatelet drugs → Cholesterol reduction → Blood pressure reduction → Diabetes control/Lifestyle → Risk of recurrence
→ ECG → Atrial fibrillation → Oral anticoagulants → Cholesterol reduction → Blood pressure reduction → Diabetes control/Lifestyle → Risk of recurrence
Page last reviewed: 05 May 2020
