Reference no: EM133585181

Sullivan is 64 male who presented to the emergency room today with a chief complain of shortness of breath when he woke up this morning. Sullivan call 911 and EMS tested his oxygen saturation and was reported to be 48% on room air. He stated that he smokes a cigar after which he became progressively dyspneic. In the emergency room he was found to have elevated white blood cell count, lactic acid of 3.2, elevated BNP of 1200 and troponin of 44. He also was hypertensive, so he started on nitro drip. Unfortunately, his blood pressure dropped down. Chest X-ray revealed evidence of blood vessel cephalization in both lung APC suggestive of CHF a trial of removing BIPAP was performed in the emergency room, but the patient desaturated again and became short of breath, so he is currently on bipap. The patient was also found to have hyperglycemia.

Past medical history:

Cataract

Diabetes mellitus type 2 (on insulin uncontrolled)

Erectile Dysfunction

H/O colonoscopy

Hyperlipidemia

Pancreatitis

Paresthesia in right hand.

Family history:

Diabetes

Hypertension

Heart disease

Cancer (colonca, prostateca).

Question:

1. Describe the relationship between any disease and/or risk factors in PMH that may have contributed to the development of the problem (which disease likely developed FIRST that began the "domino effect?).

2. Describe the relationship between the current complaint and primary medical diagnosis.