A 60 years old male had a sudden fall in toilet. His BP was 90/50 mm Hg and PR= 100/min. His relatives repoed that he is a known case of hypeension and CAD plus had a history passing black tarry coloured stools (multiple episodes) and was regularly taking aspirin, atenolol and sorbitrate. The most likely diagnosis:: (A) Gastric ulcer with bleeding, (B) Acute MI with cardiogenic shock, (C) Acute CVA, (D) Pulmonary embolism
Answer is A. Hypotension in an elderly patient with history of aspirin intake and complaints of black stool suggests GI bleeding due to drug induced gastritis. Bleeding peptic ulcer due to NSAIDs is more frequent in individuals >60 years of age due to increased use of NSAIDs in this group.