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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 329:948-955 September 23, 1993 Number 13
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Case 38-1993— Renal Failure and a Painful Toe in a 70-Year-Old Man after an Acute Myocardial Infarct
Andrew J. King, and J. Andrew Carlson

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Presentation of Case

A 70-year-old man was admitted to the hospital for further management of a myocardial infarct.

The patient had been well until three days earlier, when substernal pain developed and was accompanied by mild dyspnea, without nausea, vomiting, sweating, or radiation of pain. He was taken to another hospital within 1 1/2 hours, where laboratory studies showed that the urea nitrogen was 47 mg (17 mmol per liter) and the creatinine 2.4 mg per deciliter (210 µmol per liter). An electrocardiogram revealed an evolving anteroseptal myocardial infarct. Nitroglycerin, morphine sulfate, aspirin, atenolol, and streptokinase (1.5 million U by vein) were given, . . . [Full Text of this Article]

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