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A 60-year-old man complaining of slurred speech and left leg paralysis

History

A 60-year-old man presents to emergency room complaining of 30 minutes of slurred speech and left leg paralysis. There is no history of lung or heart abnormality or cerebrovascular disease. Patient has history of high blood pressure and is taking anti-hypertensive medication resulting in normal office BP on multiple occasions.

Use the 'auscultation' link above to virtually listen to this patient's heart and carotid sounds.

carotid bruit patient history image


Auscultation Tips

Significant independent predictors of the presence of a confirmed cardiac lesion:

  • A loud murmur of intensity 3 or greater.
  • Best heard at the pulmonic location (2LICS).
  • Harsh sound.
  • Pansystolic murmur.
  • Systolic click.
  • Abnormal second heart sound - fixed splitting during respiration.

Authors and Reviewers

Authored by Dr. Jonathan Keroes, MD and David Lieberman, Developer, Virtual Cardiac Patient. Medically reviewed by Dr. Barbara Erickson, PhD, RN, CCRN. Last Update: 11/29/2021

A 60-year-old man complaining of slurred speech and left leg paralysis


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