Case 31-1991

Presentation of CaseA 62-year-old man was admitted to the hospital because of two contrast-enhancing cerebral lesions and a right hemiparesis.There was a history of hypertension and of insulin-dependent diabetes mellitus. The patient was in a stable state of health in other respects until three months earlier, when repeated bouts of angina pectoris developed. Two days later he was admitted to another hospital, where evidence of an acute myocardial infarct was found. The patient's hospital course was complicated by second-degree and third-degree atrioventricular block and by episodes of nonsustained ventricular tachycardia; a temporary transvenous pacemaker and a central-venous-pressure catheter . . .