A Case of IDDM with a Transient ST-Elevation on the Enectrocardiogram in Diabetic Ketoacidosis

Compared to the Cases Reported as Pseudomyocardial Infarction over the Past 20 Years

Abstract

A 49-year-old man was admitted because of thirst, general fatigue and abdominal pain. He had been suffering with a common cold for 6 days before admission and had drunk about 3.0 liters of sake over the previous 2 days. Laboratory findings on admission were plasma glucose 798mg/d_l, urinary glucose 3+, urinary ketone bodies 3+, serum potassium 7.1mEq/_l, and arterial blood pH 7.08. An electrocardiogram showed ST-segment elevation in leads V_1-4. Initially acute myocardial infarction complicated by diabetic ketoacidosis (DKA) was suspected, but the ST segment elevation disappeared 3 hours after normalization of his serum potassium. ST-segment elevation is very rare during the course of DKA. Eleven cases had been reported as pseudomyocaridal infarction over the preceding 20 years. The factors which caused ST-segment elevation in those cases and the present case are compared.