text:  Briefly   this 68 year old male with a history of coronary artery disease   diabetes mellitus   peripheral vascular disease   was admitted originally to the Podiatry Service for a left patellar mid-foot ulcer . He underwent angiogram on 2013-08-28   to evaluate his circulation and found at that time that the patient had a poor circulation to the left leg . The patient was transferred to the Vascular Surgery Service for bilateral iliac stenting at that time . The patient also at that time was followed by Cardiology and for preoperative evaluation had a stress test which was positive and he became diaphoretic but denied any chest pain . Atropine was given and heart rate returned to the 70s and his blood pressure returned to the 120s over 80s . The patient denied any orthopnea   shortness of breath   chest pain   paroxysmal nocturnal dyspnea or cough . He had occasional leg swelling . PAST MEDICAL HISTORY 1 . Coronary artery disease status post myocardial infarction in 2006 and 1997 and status post percutaneous transluminal coronary angioplasty times two . Diabetes mellitus type 2 since age 25  now currently on insulin   which is complicated by peripheral neuropathy   nephropathy and Charcot s foot . Chronic renal insufficiency . Peripheral vascular disease status post left iliac stent and right femoral stent . Hypertension . High cholesterol . Question of tendonitis . MEDICATIONS ON ADMISSION  1. Insulin 70  30   40 units q. a.m. and 40 units q. p.m. 2. Diovan 160 mg p.o. q. day . Nortriptyline 25 mg p.o. q. h.s. Norvasc 10 mg p.o. q. day . 5. Metoprolol 50 mg p.o. twice a day . 6. Hydrochlorothiazide   15 mg p.o. q. day .