Brian Davies, 79, died of myocardial infarction while under an Inpatient Treatment Order for Alzheimer's dementia at Noarlunga Hospital. He presented with cognitive decline following his partner's death and developed agitated, paranoid behaviour requiring sedation with benzodiazepines and antipsychotics. He suffered an NSTEMI on 10 March 2019 with rapid atrial fibrillation, managed medically rather than invasively given his dementia and behavioural disturbance. The coroner found care appropriate throughout both admissions. The case illustrates challenges in managing acute cardiac events in elderly patients with advanced dementia and behavioural disturbance, and the tension between cardiac monitoring/intervention and patient quality-of-life goals in this context. No preventable factors were identified.
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Specialties
geriatric medicinepsychiatrycardiologyemergency medicine
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