A 72-year-old woman, with a history of type 2 diabetes mellitus, hypertension, hyperlipidemia, osteoarthritis, and heart failure with recovered ejection fraction presented to the hospital for a C2 laminectomy and C3-5 laminoplasty for cervical spinal stenosis. Past surgical history is pertinent for remote cholecystectomy, appendectomy.

Home medications include insulin degludec 15 units at bedtime, metformin 1000 mg twice a day, canagliflozin 300 mg daily, semaglutide 1 mg injection weekly on Sundays, rosuvastatin 20 mg at bedtime, carvedilol 12.5 mg twice a day, and losartan 12.5 mg daily. The patient last took her medications the day before surgery including half her home dose of insulin degludec.

Vitals
Body Mass Index: 26.5, Blood Pressure: 125/72 mmHg (supine) without orthostasis upon standing, Pulse 78 bpm, O2 Saturations: 97% on room air. Non-frail as estimated by Fried Frailty score.

Examination was unremarkable.

Laboratory tests, electrocardiogram, chest x-ray showed no significant abnormalities. Echocardiogram (performed 7 months prior to hospital admission) reported an estimated ejection fraction 50-55%, and no significant valvular disease with normal right ventricular systolic pressure.

Clinical Topics: Cardiovascular Care Team, Dyslipidemia, Heart Failure and Cardiomyopathies, Prevention, Valvular Heart Disease, Statins, Acute Heart Failure, Hypertension, Geriatric Cardiology

Keywords: Canagliflozin, Diabetes Mellitus, Type 2, Carvedilol, Blood Pressure, Body Mass Index, Losartan, Rosuvastatin Calcium, Stroke Volume, Appendectomy, Dizziness, Frailty, Hyperlipidemias, Laminectomy, Laminoplasty, Spinal Stenosis, X-Rays, Metformin, Electrocardiography, Heart Valve Diseases, Cholecystectomy, Osteoarthritis, Heart Failure, Hypertension, Hospitals

< Back to Listings