Acute electrocardiogram pseudoinfarction pattern and reversible left ventricular systolic dysfunction in a patient with diabetic ketoacidosis and hyperkalemia: a case report

Atie Moghtadaie; Seyed Amir  Miratashi Yazdi; Haleh  Ashraf; Abbas Soleimani

doi:10.18502/fem.v6i1.7683

Atie Moghtadaie Internal Medicine Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Seyed Amir Miratashi Yazdi General Surgery Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Haleh Ashraf Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Abbas Soleimani Department of Cardiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/fem.v6i1.7683

Keywords: Diabetic Ketoacidosis; Myocardial Infarction; Pseudoinfarction; Signs and Symptoms; Systolic Heart Failure

Abstract

Coexisting myocardial infarction (MI) and diabetic ketoacidosis (DKA) are the most common causes of death in diabetic patients. We report a patient with ischemic heart disease manifestations who was finally diagnosed to have DKA as a predisposing factor. The case we present in this paper is a 57-year-old man who was found unconscious in a hotel and presented with complaints of vomiting, abdominal pain, and diarrhea. He had severe dyspnea and chest pain radiating to his back. He had ST-segment elevation in anterior leads on electrocardiogram (ECG), with non-obstructive coronary artery disease in the subsequent heart catheterization. MI patients should be treated with primary percutaneous coronary intervention (PCI) or fibrinolytic agents, but pseudoinfarction due to DKA responds to medical treatment. Thus, it is also important to know that coexistence of both DKA and MI is possible, and neglecting such situations can lead to lethal consequences.