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Having diabetes, hypertension, coronary artery disease and bypass surgery, dyslipidemia. Extreme tiredness & sweating. Advice?

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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.
Posted Fri, 9 Aug 2013 in Hypertension and Heart Disease
Answered by 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
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