For this case please determine the cause of coma and the prognosis for
This is a 72 year-old woman who had witnessed syncope in a department
store today. Prior to this she was feeling well. When the medics arrived
she was in v-tach. CPR was performed including three rounds of defibrillation.
Resuscitation time from syncope to a perfusing rhythm was 35 minutes.
On day 2 she was not waking up so a neurology consult was called. Inpatient
medications include Amiodarone, ASA, Metoprolol, and sq. heparin. No sedatives.
1. Chronic low back pain
4. ASCVD. Stable angina.
2. ASA 81mg qd
3. Pravastatin 20mg qd
4. Diltiazem CD 120mg bid
6. Lisinopril 10mg qd
8. NTG prn
Family History: Noncontributory
Social History: Lives with husband. One healthy daughter..
BP 142/80 HR 78
Mental Status: Coma.
HEENT: PERRLA. Positive Doll's eyes. Cold calorics positive
bilaterally for tonic deviation of both eyes. Corneal reflexes positive.
Motor (Power/Tone/Bulk): Decorticate posturing to central
Sensory: Can't test.
Reflexes: 2/4 throughout. Upgoing toes to plantar stimulation.
Coordination: Can't test.
Gait: Can't test.
Abnormal Movements: None
Other Organs: RRR without murmur. Lungs clear to auscultation.
Initial EKG: Abnormal. Sinus rhythm at 72. ST elevation
in V4-V6 indicative of acute infarction.