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Anna Garcia's Death

This is a prezi on how Anna Garcia died, a timeline of events leading to her death, and what she could have done to prevent her death

chris collins

on 22 May 2013

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Transcript of Anna Garcia's Death

Anna Garcia's Death Anna Garcia died a tragic death caused by her Splenic Artery being occluded by sickle cells, causing blood to be trapped inside of her Spleen. This caused the Spleen to become overflowed with sickled red blood cells, which caused splenic sequestration. This then led to her Spleen to become enlarged and eventually burst. Though a person can live without a spleen, the hemorrhaging of her spleen caused 500 ml of blood to enter her abdominal cavity. Because she had already had anemia, this caused her to become severely anemic. Because of the lack of blood, cells were not receiving enough oxygen and nutrients from the blood. Then, the kidneys were damaged from this which caused the kidneys to not filter blood which allowed toxins in the blood stream, and for a hormone that signals for the body to create red blood cells to not be created which increased her anemia. This led to the death of cells and the destruction of every system. How did it come to this? There were many signs throughout her life that signaled that is would happen. First, when Anna was a baby, she was taken to a hospital for a fever, being lethargic, experiencing breathing problems and being in a lot of pain. She was showing symptoms of severe anemia. Also, here abdomen was tender to touch. Her abdomen was also enlarged. This all showed signs of splenic sequestration. Splenic Sequestration is when an excess of sickle cells get trapped inside of the spleen, causing it to be enlarged. Anna had an enlarged spleen, and because she did also have sickle cell, it is most likely that this is the cause of her enlarged spleen. This could also be the cause of her respiratory problems because it can cause a respiratory infection. Because it is very painful, that is why Anna is experiencing severe abdominal pain. Throughout Anna's life, she showed that her sickled red blood cells also caused blood clots. When she was 22, one of these blood clots led to avascular necrosis. This led to her considering a hip replacement. A year before her death a test revealed her right coronary artery to be 80% occluded and narrowing of the renal and cerebral arteries. Here leg shows evidence of mild peripheral vascular disease. These events signaled that her the occlusion of her splenic artery was very well possible. Her autopsy report also showed signs that this was her cause of death. Her final autopsy report showed that her red blood cell count was at <3.5 million when she should have 4.5-5.2 million.
She had low hemotocrit levels at 25% when her normal levels should be 36-46%. She also had low hemoglobin levels at <8 g/dl, when her levels should be 12-16 g/dl. These complications mean that she is severally anemic. This was caused by the fact that her Splenic artery was occluded making it so that once blood entered the spleen it could not leave. Then, because her spleen then ruptured she lost 500 ml of blood. Anna's abdominal cavity was obviously hard and distended. Upon further inspection, it was revealed that this was caused because she had lost 500 ml of blood into her abdominal cavity. This internal bleeding is cause by the rupture and hemorrhaging of the spleen. Her left kidney also was pale and showed the beginning signs of necrosis, which was caused by her anemia. Because Anna was anemic, her liver did not get enough oxygen or nutrients, which would have caused her Kidney cells to become pale and eventually die. Also, her blue/gray nails show signs of oxygen deprivation. This showed signs of anemia which could be caused by internal bleeding There are many steps that could have been taken to prevent this tragic death. In the short term, Anna should have recognized an enlarged spleen was causing and gone immediately to a doctor. A doctor would have recognized signs of splenic sequestration and give Anna an immediate red blood cell transfusion. When Anna was young and was showing signs of splenic sequestration, a doctor could have preformed a Splenectomy A splenectomy is the surgical removal of the spleen. When the spleen is removed it eliminates the possibility of splenic sequestration but raises the chance of infection severely. Most sickle cell patients have this procedure done at a young age. The fact that she was anemic could have caused damage to all of her cells. Her nervous system could have been damaged by the lack of nutrients to the brain and spine, so cells die. Her respiratory system could be damaged by both the damage caused by lack of oxygen and nutrients damaging her lungs. Her lungs may become overworked because the body will begin to use feedback loops to increase breathing to increase oxygen levels. Anna would have been much more vulnerable to disease because her immune cells could not reach their target cells. The blood filtering system would also be damaged because of the pooling inside of the spleen. This would cause a major drop in hemoglobin levels which would cause there to be an oxygen deficiency because oxygen is the thing that carries oxygen. Her urinary system will be affected because the body will try to get rid of the excess waste not being filtered by the spleen. The kidneys may become overworked as well as the bladder. Also, because the spleen is not functioning properly, it can cause infection to other parts of the body, which would damage multiple systems. When the spleen enlarges, it could push upon the stomach and cause anorexia. Anorexia can cause malnourishment and dehydration, which when paired with anemia can be extremely dangerous because your cells will die from malnourishment. This can also cause the muscles of your heart to die, which will cause blood to not be able to get to your cells as easily, and for the heart to be overworked. Also, the spleen could push against the diaphragm. This could cause severe breathing problems that would cause less oxygen intake and a larger strain on the lungs. Because of the already low hemoglobin levels and the fact that sickled red blood cells, and anemia, there will be a severe lack of oxygen. This will also lead to the destruction of organs and systems. Blood clots are always a serious issue. Blood clots are when the blood trying to reach cells is blocked, causing blood flow to be be restricted. In Anna, her Splenic Valve was clogged with sickle cells because sickle cells are very sticky. This caused her blood to enter her spleen, but not leave, which lead to its enlargement. Blood clots can destroy any cell becase when blood clots form they cut off blood supply to cells. When a blood vessel becomes to full, it can burst. A blood clot in other parts of the body can cause serious issues such as strokes. Anemia can have a severe affect on the body. Firstly, because of the lack of oxygen reaching cells, cells will die. This can damage all of the body's systems. With a hemotocrit level as low as 25% paired with sickled blood cells, and low hemoglobin levels, her cells had extremely low oxygen. Anemia also affects the cardiovascular system because the heart wants to pump the blood faster so that cells can get enough oxygen, but because the anemia may be damaging the heart tissue, the heart is also being injured and overworked. Increased breathing may happen because the body will try to increase the intake of oxygen. When the kidneys begin to fail, a lot of complications can be set in. Firstly, the body cannot remove the toxins from the blood well, which can hurt cells of the body. The kidneys also regulate the amount of water in the body. When the kidneys are not regulating the water, the body will become dehydrated which can lead to malnourishment of cells. The kidneys also produce hormone called erythropoietin that stimulates the formation of red blood cells. When erythropoietin is not present, the bodies anemia would worsen. Seeing that she was already dangerously anemic, this low level would undoubtedly damage the body. Also, when the body is low on glucose, the body goes to the kidneys to release glucose. When the kidneys can't do this, the body will remain at a low glucose level and then cells will not have enough energy to function. Seeing that Anna already has type 1 diabetes, her glucose already had trouble entering cells. With not enough glucose that isnt even entering cells, Anna's cells would have become very weak and died Also, stents could have been placed in her splenic artery when it was shown that the possibility of occluding with sickle cells was eviden when she was young. In the short term, Anna could have taken plarvix. Plarvix is a prescription medication that ois taken once a day to thin blood throughout the day. When symptoms of splenic requisition were first showing she could have taken Advil which is a quick acting blood thinner.
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