In the past 4 weeks, this is the third time she has had to be admitted. History: High BP, Diabetes, Swelling in left leg discoloration (blackish) Admission due to: Shortness of breath, Low SPO2, Loss of consciousness Incident 1: sugar >=300  Incident 2: After 7 days - Blood sugar 46, Unresponsive, Lungs have cough (PCO2 85), (ICU, On intermittent Ventilator + Oxygen Nasal Canula, Nebuliser), On day 2 she suffered a stroke or seizure like episode where she almost flatlined, ESR 135 Incident 3: After 4 days - Blood sugar >300, PCO2  normal (ICU again, intermittent Ventilator + Oxygen), There is dry cough still, ESR 120 Echo Tests show: 1 MID & APICAL SEPTUM, LV APEX, MID & APICAL ANTERIOR, MID & APICAL INFERIOR HYPOKINESIA 2 SEVERE LV SYSTOLIC DYSFUNCTION. LVEF 30% 3 MILD TO MODEERATE MR/TRIVIAL AR 4 MILD TR, PASP 43 MM HG 5 NO CLOTS/NO VEGETATION 1. Cause of repetitive episodes? 2. Course of action suggestion? 3. Transport to nearby big city possible via ambulance in her condition?