Nancy, a 79-year-old woman, arrives at the emergency department with expressive aphasia, left facial droop, left-sided h

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Nancy, a 79-year-old woman, arrives at the emergency department with expressive aphasia, left facial droop, left-sided hemiparesis, and mild dysphagia. Her husband states that when she awoke that morning at 0700, she stayed in bed, saying she had a mild headache over the right temple and was feeling weak. He went and got coffee, then thinking it was unusual for her to stay in bed, went back to check on her. He found she was having trouble saying words and had a left-sided facial droop. When he helped her up from the bedside, he noticed weakness in her left hand and leg and brought her to the emergency department. Her medical history includes atrial fibrillation, hypertension, and hyperlipidemia. A recent cardiac stress test was normal, and her blood pressure is under good control. Nancy is currently taking amiodarone, amlodipine (Norvasc), aspirin, simvastatin (Zocor), and lisinopril (Zestril). The provider suspects Nancy is having an acute cerebrovascular accident (CVA).
1. What role do diagnostic tests play in evaluating Nancy for a suspected CVA?
Non-contrast CT:
ECG:
Echocardiogram:
Carotid ultrasound:
2. Explain how knowing the type of CVA is an important factor in planning care.
3. Which factor in Nancy’s history is the most likely contributor to her having a CVA and why?