Intended for healthcare professionals

Practice A Patient’s Journey

Dementia with cardiac problems

BMJ 2011; 343 doi: (Published 22 July 2011) Cite this as: BMJ 2011;343:d4278
  1. Jennifer Bute, patient1,
  2. Derek Waller, cardiologist 2
  1. 147 Hapil Close, Sandford, Winscombe BS25 AA, UK
  2. 2Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
  1. Correspondence to: J Bute jennifer{at}
  • Accepted 28 February 2011

Jennifer Bute, a general practitioner, became aware of the first symptoms of dementia and cardiac problems around age 60. Since then, she has experienced episodic memory loss, loss of consciousness, and hallucinations

Shortly before my 60th birthday in August 2004, I experienced sudden weakness of my left arm lasting for 40 minutes. I did not take time off from work but phoned my general practitioner, who sent me to the transient ischaemic attack clinic. I continued to work but stopped driving. When I started driving again I always found myself seriously lost, so I bought a satellite navigation system. I was aware all wasn’t quite right and set up careful systems to ensure I did not forget things. Tasks were either completed at the time or written down, or I sent a reminder email to myself. I was sure I was “safe.”

In January 2005 I had a bizarre experience—while shopping I did not know what to do at the checkout. It was extremely difficult to pack the shopping into bags, and I looked around to gain clues as to how to do it. This alarmed me sufficiently to make me return to my general practitioner, who sent me back to the stroke clinic. They advised to stop driving and referred to a neurologist. I continued to work. While visiting a patient I was greeted by one of his visitors. I had no idea who she was, even though she was a close neighbour of mine. I also found myself unable to recognise family members in photographs.

The neurologist said there was nothing wrong, which made me more determined to cover up my difficulties. I had a defining moment in November at an important case conference, when I did not recognise the convener of the local mental health team whom …

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