31st July 2023

A 73-year-old woman with a background of ischaemic heart disease, atrial fibrillation, heart failure

A 73-year-old woman with a background of ischaemic heart disease, atrial fibrillation, heart failure, COPD, high cholesterol, and hypertension attends A&E, complaining of severe abdominal pain. On examination, her abdomen is soft and non tender. A VBG shows a metabolic acidosis and a raised lactate.

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.