What does this diagnosis mean? Any advice?

My father was hospitalized about a month ago, and now they’re basically discharging him because they aren't sure how to proceed with his care. Doctors, I was wondering if you might have some advice—what should our next steps be? He isn't ready for physical rehab yet, mainly due to an unresolved blood clot in his left atrium.

Diagnosis:
Ischemic stroke in the right MCA region.
Left-sided hemiplegia.
Hypertension.
Hyperlipidemia.
Type 2 Diabetes and Blood Clot
Blood clot in the left ventricle.
Status post myocardial infarction.
Stenosis Aca right 35% and left 20%.
Status post thrombophlebitis of both lower legs, stage II.
Status post cholecystitis.

Man, this is such a brutal cocktail of diagnoses to deal with... I mean, how do you even begin treating a stroke and its aftermath when there's a blood clot just hanging out in the left ventricle, ready to trigger another stroke at any second? It’s a total catch-22. How aggressive can you get with the clot without making the neurological situation in the brain go from bad to worse? You’ve got carotid artery stenosis, a confirmed infarct with god knows how much myocardial damage, left-side paralysis, Type 2 Diabetes and Blood Clot issues, plus high blood pressure... honestly, it's overwhelming. I totally get why the doctors are saying they're stumped.

Look, nobody on here is going to have a magic answer for you. With a list of diagnoses like that, I can only imagine the mountain of test results involved—neurology, cardiology, endocrinology, you name it. Personally, if I were in that position, I’d lean heavily on whatever the vascular surgeon recommended, since their report is probably the most critical piece of the puzzle right now. At the end of the day, given everything on the table, I’d be seriously questioning whether aggressive intervention makes sense versus just focusing on managing the blood pressure and sugar levels, while trying to ensure some semblance of quality of life without constant pain or bedsores.

Sending nothing but good vibes your way.

driftingfox19 said:My dad ended up in the hospital a month ago and now they're basically trying to discharge him because they've run out of ideas. Doctors, any advice here? What are we supposed to do? He can't even start rehab yet because he still has an untreated thrombus in his left ventricle.

diagnosis:
Ischemic stroke, right MCA region.
Left-sided hemiplegia.
Hypertension.
Hyperlipidemia
Type 2 Diabetes Thrombus
Left ventricular thrombus
Status post myocardial infarction
Right Carotid stenosis 35% and Left Carotid stenosis 20%
Status post thrombophlebitis, right lower leg, stage II
Status post cholecystitis

How old is he? Look, from where I'm sitting, the absolute priority is this: get that blood pressure under control with meds, stay on top of the cholesterol stuff, and dial in those glucose levels perfectly. He’s probably already on some kind of blood thinner—whatever they gave him, whether it's aspirin or heparin—and you can't mess around with that. Take it seriously. As for the Carotid, it doesn't look like the narrowing is bad enough for surgery yet (at least, that's my take). You really need to get a solid opinion from a decent cardiologist regarding his heart and that LV thrombus, plus a vascular surgeon or cardiac surgeon to weigh in on the clot itself. Bottom line: for now, your main job is making sure his blood pressure, glucose, and lipids are strictly managed and that he actually takes his prescribed blood thinners!!

Thanks so much for all the answers.

He’s exactly 50 years old. I suppose all of this is just the result of him not taking very good care of himself over the years.

But... what is your prognosis regarding his future? Is there any chance for actual progress, or do you think I might see him walking and living a normal life again?

driftingfox19 said:Thanks for all the input.

He’s hit exactly 50. But honestly, this whole mess is just the fallout from him living life way too recklessly.

Anyway... what’s the actual outlook here? Is there any chance of real progress—like, am I actually going to see him walking around and living a normal life again?

The big thing is keeping his blood pressure and glucose levels in check, plus staying on top of those anticoagulants if his doctor put them on the script. As for the neurological side of things, it’s hard to give a straight answer. Recovery from a stroke is a total wildcard; some people bounce back better than others, while some struggle more. It really depends on which part of the brain took the hit and how extensive the damage was. Working with a physical therapist is non-negotiable if you want any kind of rehab results. You should also make sure he sees a neurologist regularly so you can talk shop about the long-term effects and what the options are for regaining lost functions. Not gonna sugarcoat it—he probably won't be exactly who he was before the stroke, but putting in the work during rehab is the only way to find out how far he can get. Also, keep a close eye on that clot in his left ventricle. As long as that thing is sitting there, the risk of another stroke stays high. Check with the docs about whether surgery or something similar is even an option, like I mentioned earlier.