Question: A 53-year-old man with a medical history of heavy smoking, alcohol intake, hypertension, and diabetes was admitted for acute epigastric pain and dyspnea occurred while walking. His past medical history was negative for cardiac and gastrointestinal diseases. At initial evaluation he had high-grade fever without chills, intense asthenia, and alimentary vomiting. On physical examination, he was found to have mild epigastric tenderness; the blood pressure was elevated (190/100 mm Hg) and the glucose test was 326 mg/dL.