A 50s M comes in cc difficulty typing at work and a limp in his right leg. He was fine when he went to bed last night. His pmh is significant for cad and htn. He had a diagnostic cardiac cath two days ago which showed moderate triple-vessel disease. The access site was his R UE. His VS and exam are normal. What do we do next?
In terms of difficulty typing, is this secondary to right arm weakness/pain- could this be a median neuropathy? Differential should include vascular (pseudo-aneurysm compressing a nerve) and neurological etiologies given arm and leg complaints (embolism post cath- did the catheter accidentally dislodge a clot or break some plaque on the arterial wall and send it shooting off somewhere else?). I would start with a detailed neuro/vascular exam but anticipate requiring a CT/MRI to evaluate further. I would also obtain basic labs- r/o electrolyte disturbance, LFTs/CK (?assume high dose statins recently started though symptoms seem very acute to be related to statins).