Table of Contents
Washington University Experience | PERIPHERAL NEUROPATHY | 16 DIABETIC NEUROPATHY | 1 Symmetrical Sensorimotor Neuropathy | 7A0 Case 7 History
Case 7 History ---- The patient was a 76 year old man with a history of coronary artery disease status-post 3 myocardial infarcts (1985,1991 and 1994. His past medical history included diabetes mellitus with insulin requirement since 1984, peptic ulcer disease diagnosed in 1993, carotid artery disease diagnosed in 1994, hypertension, severe peripheral vascular disease, degenerative joint disease, and history of E. coli urosepsis. In 7/95 he was diagnosed with prostate adenocarcinoma. The patient was a smoker for 40 years but had quit 20 years ago. He had symptoms of hemoptysis since 1994 with unknown etiology. In 10/95, the patient suffered from a sudden onset of precardial chest pain relieved by nitroglycerin. However, five minutes later, the patient experienced nausea and emesis and re-occurrence of cough and chest pain associated with shortness of breath. His eyes deviated upward and his body started to jerk. The seizure-like activity lasted for five minutes with loss of consciousness. The patient was taken to BH ER by ambulance. Upon arrival he was chest pain free. A chest x-ray done on admission revealed an enlarged heart and diffuse infiltrates preliminarily in both spaces of the lungs. It was considered most likely caused by congestive heart failure. CT scan of the head was negative. ECHO revealed moderate left ventricular dilatation with severe depression of global left ventricular function and extensive wall mobility abnormalities. EEG was unremarkable. The patient was successfully managed and his condition was stabilized. He was discharged from the hospital but found unresponsive at home shortly thereafter.
