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Having Diabetes, Hypertension, Coronary Artery Disease And Bypass Surgery, Dyslipidemia. Extreme Tiredness & Sweating. Advice?

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Posted on Tue, 20 Aug 2013
Question: My father in law 70 years old is a case of DM, HTN, CAD-s/p CABG2005, Dyslipidemia and APD with reasonably controlled BP and BS , gets occasional episodes( once a moth or so) of extreme tiredness & sweating,lasting about 8 to 10 hrs.B Sugars all the time b/w 110 and 160 . BP- 130/80-150/90 .No chest pain, ECG all the time -no fresh changes , cardiologist says not cardiac. What is your opinion ? autonomic neuropathy?. Kindly guide.
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Answered by Dr. Dr. Shruti Rijhwani (1 hour later)
Dear madam,

Thank you for posting your query on XXXXXXX

Well looking into the history that you are giving I see that your father in law suffers from both IHD and Diabetes Mellitus . Just on the basis of history it is very difficult to pin point the diagnosis but still we can discuss the options .

Just by looking at history it seems like cardiac cause but since you say that cardiologists feel that it is normal by doing all tests then we can rule this out . But still I would say that a coronary angiography remains the most reliable way to diagnose the blockage . In diabetic patients it is not mandatory to have chest pain even in angina.

I think you should test the sugar levels at the time he gets sweating . You should consult a diabetologist and get tests for autonomic dysfunction like evaluation for resting tachycardia , effect of respiration on R-R interval should be done . Only after complete evaluation anything can be said .

Take care.

Dr. Shruti
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Shruti Rijhwani

Rheumatologist

Practicing since :2008

Answered : 2366 Questions

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Having Diabetes, Hypertension, Coronary Artery Disease And Bypass Surgery, Dyslipidemia. Extreme Tiredness & Sweating. Advice?

Dear madam,

Thank you for posting your query on XXXXXXX

Well looking into the history that you are giving I see that your father in law suffers from both IHD and Diabetes Mellitus . Just on the basis of history it is very difficult to pin point the diagnosis but still we can discuss the options .

Just by looking at history it seems like cardiac cause but since you say that cardiologists feel that it is normal by doing all tests then we can rule this out . But still I would say that a coronary angiography remains the most reliable way to diagnose the blockage . In diabetic patients it is not mandatory to have chest pain even in angina.

I think you should test the sugar levels at the time he gets sweating . You should consult a diabetologist and get tests for autonomic dysfunction like evaluation for resting tachycardia , effect of respiration on R-R interval should be done . Only after complete evaluation anything can be said .

Take care.

Dr. Shruti