विवरण
Heart disease is a very common and serious condition which can cause death of both men and women. With diabetes the chances of having heart disease or stroke increases,as the blood sugar increases the chances of damaging the blood vessels and the nerves that control the heart.
Today our guest speaker is going to talk about the high risk complications related to diabetes.
सारांश
- A 68-year-old male with a 20-year history of type 2 diabetes, well-controlled on metformin, presented with retrosternal burning after exercise, indicating stable angina. He had stopped metformin on his own, leading to uncontrolled diabetes and cardiac complications. Initial investigations included ECG and CT coronary angiography to confirm the diagnosis. CBC counts were advised to rule out anemia, which can exacerbate angina.
- Treatment focused on increasing oxygen supply to the heart through pharmacological interventions like aspirin (antiplatelet) and nitrates (vasodilators), and possibly beta-blockers. In severe cases, angioplasty or stent replacement was considered. A key aspect of prevention would have been adding a DPP-4 inhibitor to his metformin regimen, avoiding weight gain associated with sulfonylureas or insulin, and addressing his fear of injectable medications.
- A 35-year-old male with type 1 diabetes presented with chest pain and ECG findings suggesting anterolateral myocardial infarction. While CKMB was initially tested, troponin was a more specific cardiac biomarker. A 64-year-old female with a 30-year history of type 2 diabetes presented with fainting after getting up, prompting a discussion of autonomic neuropathy and ischemic heart disease.
- The patient's low blood pressure (90/60) was revealed, suggesting orthostatic hypotension, a symptom of autonomic neuropathy. Such patients are at risk of silent myocardial ischemia and sudden death due to impaired pain sensation. Management involves autonomic function tests, treating underlying heart conditions, and addressing symptoms like orthostatic hypotension through diet (high salt, high fluid) and medication (fludrocortisone). Modifications to diabetes management for the female patient should include stopping the sual Ura and start insulin.
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