A 60 year old male had a sudden fall in the toilet, his BP was 90/60 mm Hg and pulse was 100 per minute. His relatives repoed that his stool was black/dark in color. Fuher careful history revealed that he is a known case of hypeension and coronary aery disease and was regularly taking aspirin, atenolol and sorbitrate. The most likely diagnosis is?
On examination of vitals where BP is low and pulse is increased, CVA is ruled out as stroke presents with cushing reflex (Bradycardia and hypeension). Pulmonary embolism develops in setting of hypercoagulable state which is unlikely as he is taking aspirin for long time Since patient is taking aspirin, it cuts the risk of MI and there is no history of chest pain or ECG findings given The diagnosis points to gastric ulcer with bleed with of history of aspirin intake plus passage of black stools plus features of shock due to blood loss.
Gastric ulcer with bleeding
Acute myocardial infarction with cardiogenic shock
Acute CVA
Pulmonary embolism
Peptic Ulcer Disease