A 93-year-old man with extensive cardiac history died of ischaemic heart disease while detained under the Mental Health Act. He presented with delirium likely secondary to urinary tract infection from an indwelling catheter. Despite aggressive behaviour and refusal of care, Mental Health Act detention was deemed appropriate and lawful. When acute coronary syndrome was identified on 19 March with ECG changes and elevated cardiac enzymes, angiography was considered unrealistic due to his agitation and non-cooperation. He had previously expressed a wish not to be resuscitated. Palliative management with heparin, GTN and morphine was instituted. He died the following evening. The coroner found his care appropriate and thorough throughout his hospital admission.
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