A 63-year-old woman with a 1-year history of type 2 diabetes (treated with diet, glibenclamide at half the maximum dose, and simvastatin [40 mg, administered in the evening]) and no other significant past medical problems was admitted to the accident and emergency department with a 90-minute history of crushing central chest pain. After the onset of chest pain, the patient had been attended to by paramedics, who gave her an aspirin tablet to chew. On arrival at hospital, she received nitrates, which did not relieve the pain, followed by analgesics.Further investigation showed that her serum markers were elevated to more than twice the upper limit for serum creatine kinase and serum creatine kinase isoenzyme B. Her electrocardiogram showed signs of an acute anterior myocardial infarction (MI). Her condition quickly stabilized.After initial treatment, the patient was admitted to the coronary care unit under the care of a cardiologist, and then referred to the diabetes team for management of her diabetes during the acute and subsequent phases of MI.Sunday, July 22, 2007
Clinical case of diabet
A 63-year-old woman with a 1-year history of type 2 diabetes (treated with diet, glibenclamide at half the maximum dose, and simvastatin [40 mg, administered in the evening]) and no other significant past medical problems was admitted to the accident and emergency department with a 90-minute history of crushing central chest pain. After the onset of chest pain, the patient had been attended to by paramedics, who gave her an aspirin tablet to chew. On arrival at hospital, she received nitrates, which did not relieve the pain, followed by analgesics.Further investigation showed that her serum markers were elevated to more than twice the upper limit for serum creatine kinase and serum creatine kinase isoenzyme B. Her electrocardiogram showed signs of an acute anterior myocardial infarction (MI). Her condition quickly stabilized.After initial treatment, the patient was admitted to the coronary care unit under the care of a cardiologist, and then referred to the diabetes team for management of her diabetes during the acute and subsequent phases of MI.
