{"ops":[{"insert":"A 50 year old woman presents with pain and numbness of her left hand for 3 hours. These symptoms started abruptly, and have worsened over time.\n\nOn close questioning, she reveals a history of recurrent palpitations for many years, which has not been investigated.\n\nHer medical, surgical, and family histories are unremarkable.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-S-045_en.png"}},{"insert":"\n"}]}
2
Investigate
CT Arteriogram L/Arm
{"ops":[{"insert":"The CT Arteriogram of the left subclavian artery shows pristine vessels up to the bifurcation of the brachial artery, at which point there is an acute cutoff, with a lack of contrast beyond that point.\n"}]}
ECG
{"ops":[{"insert":"The ECG shows an irregularly irregular rhythm, with a rate of 98 bpm. The baseline is irregular and P waves are absent. The QRS complexes, T waves and QT segments are normal.\n"}]}