Dr. Waqar Anwer (Emergency Medicine) needs a second opinion on this medical case.
A 56/M pt present to ED with the c/o moderate uneasiness and heartburn. He had been diagnosed with type 2 diabetes mellitus 4 years earlier. He is suffered from Hypertension, Dyslipidemia, diabetic nephropathy, diabetic retinopathy and peripheral neuropathy. Currently His medications included Telma 40, Ecospirin AV Gold 20 and metformin
O/E BP 150/80 mmHg, reduced vibration sense in his feet.
ECG is performed, based on ecg findings, Pt denied chest, arm or jaw pain or discomfort; shortness of breath; palpitations; nausea; indigestion or sweating.
In view of the ECG changes, What is the most likely diagnosis and treatment