Abstract
We report the case of a 23-year-old diabetic man who was admitted to hospital with ketoacidosis. His electrocardiogram (ECG) showed sequential changes of acute pericarditis without pericardial effusion. These changes were transient: after 120 hours the ECG returned to normal.
A 23-year-old man without a history of diabetes, who had had increasing thirst, polyuria, nausea and vomiting of two weeks'duration, was admitted to the hospital with severe retrosternal chest pain and general fatigue. On examination, he was obviously dehydrated and slightly drowsy. Initial investigations showed urine ketone body (3+), urine sugar (4+), blood ketone body 7.7 mmol/l, arterial blood pH 7.29, BE-10.8 mmol/l, and blood glucose 498mg/dl. The ECG taken at admission showed definite ST elevation in leads I, II, III, aVF, and V1-6, suggestive of acute pericarditis. However the echocardiograms did not show any pericardial effusion. The ECG abnormalities and clinical symptoms were largely resolved after initiation of treatment with intravenous fluid and continuous Actrapid insulin infusion.
