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Laboratory Analysis:

Complete Blood Count (cbc) have no abnormalities

Full Cholesterol Panel

Total Cholesterol - 389 mg/dL (too high)

LDL - 243 mg/dL (higher than average)

HDL - 60 mg/dL (average)

Triglycerides - 145 mg/dL

Fasting Blood Sugar - 85 mg/dL (normal)

As a result, LDL and total cholesterol levels exceed normal

Anna had familial hypercholesterolemia

LINK

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Toxicology:

No evidence of alcohol

Statins found  (drugs that are used to reduce fat in the blood)

Blood Glucose Level: 280 mg/dL

surpassed Hypertension Stage 2 and was in obvious need of Emergency Care

External Examination:

Lungs appear normal and have not been infiltrated

Internal Examination:

Evidence of mild peripheral vascular disease in the left leg.

arteries are narrowed due to plaque and reduced blood flow

Cardiovascular System:

concentric left ventricular hypertrophy

thickening of the walls of your heart's main pumping chamber (left ventricle).

mild mitral valve prolapse

mitral valve does not close adequately

A stent was placed in the left anterior descending coronary artery; however, scar tissue and clots partially block or occlude the lumen of the vessel. The right coronary artery is 80% occluded. Narrowing is also noted in the renal arteries as well as the cerebral arteries and provides evidence of atherosclerosis.

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Chief Complaint:

Sees cardiologist after two incidents of self resolved chest pain

admittedly consumes a daily diet high in calories and fat

drinks three glasses of wine daily after work

Former athlete, but now only does Yoga to deal with her stress.

Family History of early heart disease, uncontrolled hypertension, father had a heart attack at 41 years old

Physical Exam:

tachycardic: average resting heart rate ranges from 90 - 105

claims tingling sensation in right calf, but no swelling found

Cardiac Testing:

Treadmill stress test shows that:

blood pressure increased drastically

EKG shows premature ventricular contractions

walked for 8 minutes

max speed: 3.5 mph

elevation: 2%

max blood pressure: 190/110

LINK

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Breakfast:

One cup whole milk

One Biscuit

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Sunday August 12th, 2012
Breakfast:

One cup of cheerios

Half cup of skim milk

Half cup of blue berries

Lunch:

One cup low fat strawberry yogurt

One cup canned low sodium vegetable soup

Twelve ounce can cola

Snack:

One single serving bag of potato chips

Dinner:

Two slices thick crust pepperoni pizza

Two cups of tossed salad

Four tablespoons Cesar salad dressing

Dessert:

One cup vanilla ice cream

Half cup mini marshmallows

Five oreo cookies

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Saturday August 11, 2012
Breakfast:

Two egg whites scrambled with no butter

Two slices thick turkey bacon

One slice whole wheat toast with one pat butter

One cup coffee with artificial sweetener and one tbsp light creamer

Lunch:

One Twelve Ounce can Sprite

One Turkey Sandwich

Two slices whole wheat bread

Three slices of Turkey

One slice cheddar cheese

Half tbsp mayo

Sixteen fat free tortilla chips and salsa

Snack:

A fourth cup dry roasted peanuts

One small apple

Dinner

Half cup of apple juice

Six ounce salmon

One cup brown rice cooked with salt and butter

One cup steamed broccoli

Dessert:

Half cup of sugar free lemon gelatin

LINK

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Anna was diagnosed with sickle cell anemia at the age of 14 months.
LINK

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Four Tests Done:

Urinalysis: Positive for Bacterial Infection

Gross Morphology: Had serratia marcescens

Gram Stain: Was bacillus and gram negative

Bacterial Identification: Anna definitely had serratia marescens.

LINK

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Anna @ 14 years old

Diagnosed with sickle cell disease as an infant and no other major illnesses until now

Recent check up entails:

Fatigue

Everyday normal activities requires rest before hand and during

Constant thirst and urination

Lost 10 pounds in between visit

She has not changed diet or exercise

Family History of High Cholesterol and Heart disease

Physical Examination:

Normal Pulse

No signs of edema but there is a tingling sensation she says

Ears, nose, glands, and throat look normal

Lab Analysis

CBC results are normal

Strep tests are negative

Glucose in urine

LINK

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Blood:

Traces of Hydroxyurea

External:

Finger nails are blue and gray

LINK

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Blood

AC1 is 11 percent

Urine

No non - prescription drugs or overdose

Significant protein in urine

Ketones in urine

Lens of right eye is cloudy

Both eyes had swollen blood vessels

Abnormal blood vessels in left retina

Lots of plaque was building up in the teeth, gums were beginning to recede

4 to 5 unfilled dental cavities were unfilled

Left kidney is pale and shows signs of early necrosis

Right kidney is normal

LINK

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Body's Condition:

Blood Glucose was 280 mg/dL

125 mL of partially digested food

no evidence of toxins or poison

Esophagus were gray pink

Stomach, small and large intestine are not damaged

LINK

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Body's Condition:

Edema: Both ankles are swollen

Vomit

Red injection sights in her left thigh

Clothes are stained with blood

No evidence of overdose

Lack of Oxygen

LINK

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LACK OF OXYGEN

In accordance to 1.3, Anna lacked oxygen during her death.

Specific Carbohydrate Diet

KIDNEY DISEASE

In accordance to Autopsy 2.3.3, Anna's kidney's cells were dying due to disease,  which is also known as necrosis.

KETO ACIDOSIS

In accordance to Autopsy 2.3.3, ketones were found in Anna's urine sample.

INFECTION

In accordance to Medical History 5.1.1, we determined that Anna had a Urinary Tract Infection and was infected with bacteria.

SPLENIC SEQUESTRATION

In accordance to Autopsy 1.3, Anna's was swollen due to Specific Carbohydrate Diet.

CORONARY ARTERY DISEASE APRIL 2017

In accordance to Autopsy 4.1.2, Anna was given a stent instead of an angioplasty. It was placed due to plaque build up in her left descending coronary artery. Her occluded right coronary artery showed signs of atherosclerosis.

ACUTE CHEST SYNDROME April 2017

Acute chest syndrome is usually a vaso occlusive crisis of the pulmonary vasculature which is commonly seen in patients with sickle cell anemia. Since Anna had already been confirmed to have sickle cell anemia when she was 18 months, we know that this theory already has potential.

STROKE April 2017

Since she had a stent placed in, it demonstrates how her arteries are suffering from plaque buildup. A stroke is caused by the continuation of plaque build up. Potentionally, Anna suffered a stroke.

UNIT 4 THEORIES:

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ALEX GARCIA

Divorced with Anna and married another younger suitor.

Potentially had financial issues with Anna because of her medical background.

ERICA PIEDMONT

Alex's second wife, following Anna Garcia.

Witnesses claim she was outside of Anna's house the night before her death in a car.

DOUG GREENE

Neighbors with Anna

Was seeing Anna romantically, but she ended a week before her death.

LUCY LEFFINGWELL

Is Anna's best friend and business partner

Was in a long term argument with Anna because Anna refused to expand their business.

The day before Anna died, she left work early and told Lucy she had  something to take care of.

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CLUES

Anna was wearing a sweated although the weather was hot.

Anna's dog was left barking for a full two hours the morning of her death.

Front door was not answered, so police broke it down.

Room Temperature: 73 degrees in the house

Anna was in the hallway lying face down

FORMS OF EVIDENCE

Blood Drops

Syringe

Spilled Orange Drink

Vomit

Hair

Footprint

Overturned Table

Pills

TIME OF DEATH

Died around 7 am

OBSERVATIONS

Table was flipped over and has a fingerprint and streaks of red substance on it.

Syringe was filled a third way

Anna is face down in a fashion as if she fell.

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PILLS

Pills found at the scene are aspirin because the substance reaction

HAIR

Hair at the scene belongs to Anna Garcia.

BLOOD

Blood found at the scene is Type B

Two people had blood type B:

Anna Garcia and Alex Garcia

Therefore, blood at scene can belong to either of them.

Blood fell from a height around 60 cm.

Blood determined to belong to Anna Garcia.

FINGERPRINT

Fingerprint matches Alex Garcia

Met the night before as his alibi to discuss their divorce

SHOE PRINT

Shoe print matches Anna Garcia's shoe