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Anna Garcia's Cause of Death

Anna Garcia

Decendent: Anna Garcia

Age: 38

Weight: 164 lbs

Height: 64 inches

Race: Hispanic

Sex: Female

by: Emily Gharabegi

Anna's Diabetes

Anna's Sickle Cell

Diabetes

  • Anna was diagnosed with Sickle Cell Anemia at 14 months old when she came to the emergency room with symptoms including: fever, abnormal breathing, and pain.
  • Sickle Cell Disease causes red blood cells to form into the shape of a crescent and become hard. When they are in the crescent shape, sickle cells often get caught in arteries and form clots.
  • This affects the Circulatory System because it alters the shape of red blood cells and when these sickle cells clot in arteries it slows or even stops blood flow to that an area. It also prevents white blood cells from reaching and killing bacteria in some areas of the body.
  • Sickle Cell causes anemia which is a low blood cell count. Anna had a low hematocrit of 31%. Low hematocrit levels means there are less red blood cells supplying oxygen throughout the body.
  • Sickle Cell Anemia contributed to Anna’s death by causing a clot. There was already glucose build up in the cerebral artery which narrowed the diameter of the artery. Sickled red blood cells got caught in the plaque forming a clot. This clot stopped healthy red blood cells from reaching the frontal lobe.

  • Anna Garcia was diagnosed with Type 1 Diabetes at the age of 14.
  • Anna had excessive thirst and urination.
  • This shows that there were high levels of glucose in her blood because her kidneys were trying to filter out the glucose through urination but needed water was urinated as well causing excessive urination and more need for water.
  • She experienced tingling sensations in the feet suggesting neuropathy.
  • This shows her diabetes was affecting the Nervous System because constant high glucose levels in the blood ruin nerve fibers, especially in the limbs. This causes loss of feeling and the tingling sensation.
  • There were ketones present in Anna's urine
  • This affects the Urinary System because when cells don't get the glucose they use for energy they break down fats which give off a byproduct: ketones. This builds up in the kidneys and makes the blood acidic.
  • The constant high glucose levels that Anna had, as proven above, causes other problems such as hypertension, heart disease, and high cholesterol levels.
  • Anna's blood glucose levels were at 280 mg/dL which is above the normal range of (70-125 mg/dL) on the day she died.
  • This lead to her stroke because excess glucose in the blood contributed to plaque build up in the arteries. With glucose creating plaque build up, Anna's other health issues built on top if it causing the stroke.

Anna's Urinary Tract Infection

Careers that Played a Vital Role in Anna's Life

Symptoms of a Stroke

  • Anna contracted a Urinary Tract Infection after a visit in the hospital for a sickle cell crisis.
  • Anna experienced symptoms such as a persistent urge to urinate but only a small amount of urine passing and a slight pink coloration in the urine.
  • After a urinalysis, Gross examination, Gram staining, and Biochemical Testing Anna had the bacteria, Serratia Marcescens, in her body which caused the UTI.
  • The Urinary Tract Infections affects the Immune System because it causes the system to send attacks (T cells and B cells) to kill the infection. During the attack these cells die which weakens the immune system until it can create these cells again.
  • The Urinary Tract Infection lead to Anna’s death because studies show that bacteria contributes to atherosclerosis when they remain along the blood vessels. This is especially because the sickle cells in Anna's blood stream could have prevented some of the phagocytes, T cells, and B cells from reaching the infection sight. The bacteria most likely added onto the plaque build up consisting of cholesterol and glucose. Again, the sickled cells caught onto the plaque developing a clot.

Cause of Death

Long Term Prevention

  • Trouble with speaking and understanding
  • Paralysis or numbness of the face, arm or leg
  • Trouble with seeing in one or both eyes
  • Headache with vomiting
  • Trouble with speaking

Medical Risk Factors

  • High blood pressure
  • High cholesterol
  • Diabetes
  • Abnormal heart rhythm

It was concluded that an Ischemic stroke lead to Anna's death. This was finally concluded when facial drooping in the left side of the face was visible after rigor mortis. Sectioning of the brain revealed a significant blood clot or blockage in he frontal lobe. Brain cells around the blockage are necrotic which indicates an Ischemic stroke.

  • A dietician could have played a vital role in Anna's life, helping her with her diabetes and high cholesterol. The dietician would have made meal plans for Anna that would provide Anna with all the nutrients that are healthy and limit meals with high cholesterol, sugar, and unhealthy fats. A dietician could have also made an insulin administration schedule to insure Anna would take insulin at appropriate times. These actions would limit glucose and cholesterol build up in Anna's blood vessels. This would prevent atherosclerosis which would open up Anna's artery walls.
  • A cardiologist could have played a vital role in Anna's life as well. A cardiologist could have prescribed medication that would lower Anna's blood pressure such as Diuretics. They could have also prescribed Statins which lower cholesterol levels. Lowering blood pressure would widen the diameter of Anna's arteries allowing for faster and easier blood flow. Lowering cholesterol would prevent atherosclerosis.
  • These two careers would aid in the prevention of Anna's stroke because they would have helped clear plaque build up along Anna's artery walls and dilate them. Blood could then flow smoothly to areas of the body providing oxygen.

Short Term Prevention

Factors that Lead to Anna's Stroke

  • To prevent glucose build up along the arteries, Anna should have taken her insulin routinely.
  • Anna should have limited her saturated fat, sodium, cholesterol, alcohol, and sugar intake. This would limit cholesterol and glucose levels in the blood.
  • Anna should have eaten more fruits, vegetables, and lean meats.
  • Anna should have exercised 60 minutes a day for at least 4 days a week. This would allow cells to take in the glucose and reduce her high blood pressure.
  • Another way Anna could have reduced her hypertension was to manage her stress.
  • Anna should have constantly washed her hands and taken medication when sick so bacteria would have been fought off.
  • Anna had
  • Stage 1 hypertension
  • Type 1 diabetes
  • Ventricular hypertrophy and Mitral valve regurgitation
  • Familial Hypercholesterolemia
  • Sickle Cell Anemia
  • Urinary Tract Infection
  • Anna could have taken insulin hours before her death if she tested her blood glucose levels and found out they were high.
  • Anna should have taken the Statins that were prescribed to her for her high cholesterol.
  • Minutes before her stroke or when she began feeling signs of the stroke she should have dialed 911 for help.
  • Anna could have taken aspirin when beginning to feel mild signs of a stroke. There was aspirin spilled at the crime scene but it seems Anna took the aspirin when it was too late.
  • Other than those aspects, there are not many ways to prevent a stroke when symptoms appear. The best way to prevent a stroke are long term.

Thank You!

Anna's Cardiovascular Conditions

Atherosclerosis

  • Anna’s Medical History sheet (4.1.2) showed she had Ventricular Hypertrophy, a mild Mitral Valve prolapse, and Mitral valve regurgitation.
  • This affects the Cardiovascular System because it weakens the heart muscle due to the excessive amount of pressure put on the heart. The weakening of the cardiac muscle will slow down and weaken blood flow throughout the body.
  • There was also narrowing noted in the renal arteries as well as the cerebral arteries (which is the location of the clot that caused the stroke).
  • Anna had development of atherosclerosis which is the blockage of blood vessels
  • Anna also had stage 1 hypertension which would cause her blood vessels to narrow.
  • Anna had Familial Hypercholesterolemia which causes high cholesterol and when left untreated will cause atherosclerosis.
  • Anna’s cardiovascular conditions contributed to her stroke as well. Her hypertension narrowed the diameter of her arteries. Anna had atherosclerosis due to her Familial Hypercholesterolemia which would cause cholesterol plaque to build up along the cerebral artery along with glucose due to her diabetes. The sickle cells would then get caught in the plaque creating a clot.

Crime Scene

  • On Anna's first autopsy report (1.3.1) the examination of the head showed an injury to the right temple, which includes an open wound and bruising. There were signs of light bleeding indicating lack of blood flow.
  • Vomit was found near Anna's body. Typically, when people go into a stroke they vomit.
  • A table was flipped over showing signs of stumbling which is a symptom of a stroke. This can also explain how Anna got the wound on her right temple. The blood spatter diameter of 9.2 mm indicated Anna hit her head and bled as she was falling.
  • The aspirin pills were found at the scene because aspirin is known to prevent clots which would prevent a stroke or heart attack.

ECG

62

bpm

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