A 60 year old woman was admitted to hospital with a one week history of increasing confusion and malaise. She was discharged from hospital 2 weeks previously after receiving treatment for a non-ST-elevation myocardial infarction (with aspirin and ticlopidine). Abnormal findings on clinical examination are a low-grade temperature (37.4°C), GCS 12 (E3V4M5), jaundice, and petechiae over her arms and legs.
CXR was unremarkable and showed clear lung fields.
ECG showed normal sinus rhythm with poor R wave progression in anterior leads.
CT head showed no acute abnormality.
Written by Dr Rathai Anandanadesan
First published on 24 June 2021