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Lactic Acidosis

Herbert Lubowitz, MD; Stephen Crespin, MD; Stanford Wessler, MD; Louis V. Avioli, MD
Arch Intern Med. 1974;134(1):148-151. doi:10.1001/archinte.1974.00320190150026.
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DR. Edith Levine, Fellow, Pulmonary Division, the Jewish Hospital of St. Louis: A 76-year-old white, retired, grocery clerk was admitted to Jewish Hospital because of chest pain. Four years previously, he had similar symptoms, and a pattern of anteroseptal myocardial infarction subsequently evolved on the electrocardiogram. Since that time, he has had congestive failure that has been treated with 0.25 mg of digoxin and 100 mg of hydrochlorothiazide per day. Three days prior to his present admission, the patient experienced chest discomfort, with accompanying shortness of breath. On admission, a recent diaphragmatic myocardial infarction was confirmed electrocardiographically and by serum enzyme changes. Convalescence was unremarkable for the first week. In that time, his temperature rose to 38.3 C (101 F). Urine, sputum, and throat cultures were negative and chest films were normal. An erythrocyte sedimentation rate of 132 mm/hr suggested the possibility of Dressler syndrome, and aspirin therapy was initiated.


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