Cardiovascular System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This middle aged gentleman has presented with an interesting mix of symptoms: left sided tinnitus and unsteadiness, suggesting at a neurological deficit; and numbness in the right upper arm, and pain suggestive of arm claudication, hinting at vascular compromise.\n\nThe examination reveals several alarming signs: a colder right hand, diminished right-sided radial and brachial pulses, a significant discrepancy in systolic blood pressures between both arms, and a bruit at the root of the neck; these confirm that significant vascular compromise of the right arm is present.\n\nFurthermore, note the deviation to the right in the Unterberger stepping test. In this test, the patient is asked to undertake a few stationary steps with their eyes closed; if the patient rotates towards one side or the other (rather than staying in the same place), this is suggestive of a labyrinthine lesion on that side.\n\nA diagnosis which unifies these disparate findings would be a vascular pathology that compromises"}]}

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