acute myocardial infarction in association with coronary artery atherosclerosis
AI-generated summary
Leslie Charles Linton, a 64-year-old man with severe triple-vessel coronary artery disease, presented to Royal Perth Hospital on 15 December 2023 with an infected foot wound and acute psychosis. Initial troponin elevation was determined to be a false positive (assay interference). He was admitted to the Mental Health Unit as an involuntary patient on 21 December for management of untreated schizophrenia and suspected vascular dementia, with plans to obtain guardianship orders to enable consent for needed bypass surgery. On 30 December, he developed hypotension (90/60), initially attributed to dehydration. Despite 30-minute observations, he was found unconscious in the bathroom at 3pm and could not be revived. Post-mortem confirmed acute myocardial infarction. The coroner found his psychiatric and medical care reasonable and appropriate, noting he remained at persistent cardiac risk despite appropriate medications and that his refusal of surgery, driven by psychiatric illness and cognitive decline, complicated treatment planning.
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