scholarly journals ST-Segment Elevation and Normokalemia in Acute Diabetic Ketoacidosis: Case Report and Brief Literature Review

2020 ◽  
Vol 8 (1) ◽  
pp. 33-35
Author(s):  
S. Bryn Dhir ◽  
Abbas Husain
Keyword(s):  
Diabetic Ketoacidosis ◽  
Diabetes Mellitus Type 1 ◽  
Normal Serum ◽  
Diabetic Patients ◽  
Valuable Insight ◽  
St Segment Elevation ◽  
St Segment ◽  
Life Threatening ◽  
History Of ◽  
Cardiac Manifestations

Background: Diabetic Ketoacidosis (DKA) is a life-threatening complication of Diabetes Mellitus Type 1 (DM1) and requires prompt management; however, benign transient electrocardiographic (ECG) abnormalities with normal serum potassium levels can be seen in diabetic patients secondary to metabolic changes. Understanding the varying presentation among patients provides valuable insight into the management of this seemingly uncommon and benign diagnosis. The Case: A 24-year-old male with a history of DM1 presented to the Emergency Department (ED) with ST-segment elevation, normal potassium levels and metabolic acidosis. The patient was found to be in DKA with benign cardiac manifestations. Conclusion: The correction of underlying metabolic abnormalities in DKA and the awareness of the benign cardiac pseudo pathology on ECG allows for effective management and personalized patient care.

scholarly journals Pseudomyocardial Infarction in a Patient with Severe Diabetic Ketoacidosis and Mild Hyperkalemia

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Edgar Francisco Carrizales-Sepúlveda ◽  
Ángel Noé del Cueto-Aguilera ◽  
Raúl Alberto Jiménez-Castillo ◽  
Olga Norali de la Cruz-Mata ◽  
Mariana Fikir-Ordoñez ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Diabetic Ketoacidosis ◽  
Diabetic Patients ◽  
Serum Electrolyte ◽  
St Segment Elevation ◽  
Prompt Treatment ◽  
St Segment ◽  
Severe Hyperkalemia ◽  
Work Up ◽  
Electrocardiographic Abnormalities

A 48-year-old male with a prior diagnosis of diabetes mellitus presented to the emergency department with malaise and nausea. On work-up, he was found with hyperglycemia and high anion gap metabolic acidosis, with a blood pH<6.94. A diagnosis of severe diabetic ketoacidosis was established; serum electrolyte analysis showed mild hyperkalemia. On work-up, a 12-lead electrocardiogram was obtained, and it showed an ST-segment elevation on anterior leads that completely resolved with diabetic ketoacidosis treatment. ST-segment elevation myocardial infarction can be a precipitant factor for diabetic ketoacidosis, and evaluation of diabetic patients with suspected myocardial infarction can be challenging since they can present with atypical or little symptoms. Hyperkalemia, which usually accompanies diabetic ketoacidosis, can cause electrocardiographic alterations that are well described, but ST-segment elevation is uncommon. A pseudomyocardial infarction pattern has been described in patients with diabetic ketoacidosis; of note, most of these patients presented severe hyperkalemia. We believe this is of great importance for clinicians because they must be able to recognize those patients that present with electrocardiographic abnormalities secondary to the metabolic alterations and those that can be experiencing actual ongoing ischemia, in order to establish an appropriate and prompt treatment.

scholarly journals Metamizole-Induced Type I Kounis Syndrome

2021 ◽  
Author(s):  
Catarina Lameiras ◽  
Ana Corte-Real ◽  
Ana Órfão ◽  
Marta Mendes Lopes ◽  
Maria do Céu Dória
Keyword(s):  
Previous History ◽  
Clinical Manifestations ◽  
Type I ◽  
Kounis Syndrome ◽  
St Segment Elevation ◽  
Acute Urticaria ◽  
Coronary Syndrome ◽  
St Segment ◽  
Life Threatening ◽  
Cardiac Manifestations

Kounis syndrome (KS) is defined as acute coronary syndrome (ACS) triggered by mast cell and platelet activation in the setting of allergic or anaphylactic insults. KS is a unique and complex cause of ACS and many cases may be missed due to its highly variable clinical manifestations. In this report, we present a case of KS type I triggered by metamizole in the absence of a previous history of allergy to this drug. Following the administration of metamizole, the patient developed generalized acute urticaria, chest pain and diaphoresis. Electrocardiography (ECG) showed ST-segment elevation suggestive of myocardial infarction complicated by ventricular tachycardia. No coronary disease was observed on coronary angiography. The cardiac manifestations of KS may be life-threatening, and so it is important to appropriately recognize and treat this condition.

scholarly journals Management of ST Elevation Myocardial Infarction (STEMI) in Different Settings

2021 ◽  
Author(s):  
Rod Partow-Navid ◽  
Narut Prasitlumkum ◽  
Ashish Mukherjee ◽  
Padmini Varadarajan ◽  
Ramdas G. Pai
Keyword(s):  
Myocardial Infarction ◽  
Treatment Strategies ◽  
Management Process ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Multiple Factors ◽  
St Segment ◽  
Threatening Condition ◽  
Life Threatening ◽  
St Elevation

AbstractST-segment elevation myocardial infarction (STEMI) is a life-threatening condition that requires emergent, complex, well-coordinated treatment. Although the primary goal of treatment is simple to describe—reperfusion as quickly as possible—the management process is complicated and is affected by multiple factors including location, patient, and practitioner characteristics. Hence, this narrative review will discuss the recommended management and treatment strategies of STEMI in the circumstances.

Les facteurs cliniques qui influencent le pronostic post-infarctus à un an

1993 ◽  
Vol 18 (1) ◽  
pp. 63-79
Author(s):  
Sylvie Robichaud-Ekstrand
Keyword(s):  
Ventricular Arrhythmias ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Cardiac Events ◽  
Mortality And Morbidity ◽  
St Segment Elevation ◽  
St Segment ◽  
Prognostic Stratification ◽  
History Of ◽  
Exercise Induced

Many clinical factors influence the 1-year prognosis in myocardial infarction (MI) patients. The most important clinical determinants are the left ventricular dysfunction, myocardial ischemia, and complex ventricular arrhythmias. Some authors have found an independent prognostic value of complex ventricular arrhythmias, while others consider that ventricular arrhythmias predict future cardiac events only if associated with low ejection fractions. Other factors that have 1-year prognostic value are the following: a previous MI, a history of angina at least 3 months preceding the infarct, postmyocardial angina, and the criteria that indicate to the practitioner whether MI patients are medically ineligible for stress testing. There still remain controversies in regard to the predictive value of certain variables such as the site, type, and extension of the MI, the presence of complex ventricular arrhythmias, exercise-induced hypotension, ST segment elevation, and the electrical provocation of dangerous arrhythmias. Key words: cardiac rehabilitation, postinfarct mortality and morbidity, cardiac events predictors, postinfarct prognostic stratification

scholarly journals Diabetes Mellitus with Silent Myocardial Ischemia: A Single-Center Cross-Sectional Study of Karachi, Pakistan

2021 ◽  
pp. 56-60
Author(s):  
Muhammad Zohaib Siddiq ◽  
Shahid Hussain Memon ◽  
Anwar Ali ◽  
Tabassum Almas ◽  
Atiya Razzaq ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Ischemia ◽  
Cross Sectional Study ◽  
Silent Myocardial Ischemia ◽  
Study Patient ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
St Segment ◽  
History Of

Background: Previous studies have established the fact that diabetic patients are predominantly inclined towards silent myocardial infarction (SMI). The objective of the present study is to determine the incidence of SMI in diabetes mellitus (DM) patients. Methodology: In this cross-sectional study, patient data was gathered on a predesigned proforma regarding the detailed history of dyspnea, DM and its duration, chest pain either present or not. Those patients who had normal ECG labeled negative for SMI, while those who had either ST-segment elevation or ST-segment deviation on resting ECG were positive for SMI. Study was conducted at the National Institute of Cardiovascular Diseases (NICVD) Karachi- Pakistan. Results: The mean age of the enrolled patients was 54.21±8.65 (40-70) years. Out of 210, majority were female (51.90%).Overall, 94(44.76%) patients were obese, 122(58.09%) were hypertensive, 90(42.85%) had dyslipidemia and 98(46.66%) diabetic patients were smokers. There were 93 (44.3%) DM patients who had SMI. Moreover, 109(51.90%) patients had a family history of myocardial ischemia. Conclusion:  The SMI incidence among diabetic patients was found higher in local population. It is proposed that diabetic patients with demonstrated cardiovascular autonomic neuropathy must be screened for the manifestation of SMI.

scholarly journals STEMI due to septic embolism from prosthetic aortic valve Aspergillus spp. Endocarditis in an immunocompetent patient.

2021 ◽  
Author(s):  
coral Serrano Arroyo ◽  
Luis Sánchez Trujillo ◽  
Alan León Bojórquez ◽  
José Leal Franco ◽  
Amalia Castro Rodríguez ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Immunocompetent Patient ◽  
Artery Occlusion ◽  
Etiologic Agent ◽  
Pathology Report ◽  
St Segment Elevation ◽  
Replacement Surgery ◽  
St Segment ◽  
History Of ◽  
Artery Disease

A 65-year-old man with a history of aortic valve replacement surgery and non-coronary artery disease was admitted to the emergency department with acute ST-segment elevation myocardial infarction (STEMI). Coronary angiography revealed left anterior descending (LAD) artery occlusion, which was treated successfully with angioplasty. The patient developed obstructive valvular dysfunction, and large vegetation was observed on echocardiography. The patient subsequently developed irreversible septic shock and died several days later. The pathology report identified Aspergillus as the etiologic agent.

scholarly journals Antiphospholipid Syndrome - A Case Report of Pulmonary Thromboembolism, Followed with Acute Myocardial Infarction in Patient with Systemic Sclerosis

2015 ◽  
Vol 3 (4) ◽  
pp. 705-709 ◽  
Author(s):  
Marija Vavlukis ◽  
Irina Kotlar ◽  
Emilija Chaparoska ◽  
Bekim Pocesta ◽  
Hristo Pejkov ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Pulmonary Embolism ◽  
Systemic Sclerosis ◽  
Antiphospholipid Syndrome ◽  
Total Occlusion ◽  
St Segment Elevation ◽  
St Segment ◽  
History Of ◽  
The Right

AIM: We are presenting an uncommon case of pulmonary embolism, followed with an acute myocardial infarction, in a patient with progressive systemic sclerosis.CASE PRESENTATION: A female 40 years of age was admitted with signs of pulmonary embolism, confirmed with CT scan, which also reviled a thrombus in the right ventricle. The patient had medical history of systemic sclerosis since the age of 16 years. She suffered an ischemic stroke 6 years ago, but she was not taking any anticoagulant or antithrombotic medications ever since. She received a treatment with thrombolytic therapy, and subsequent UFH, but, on the second day after receiving fibrinolysis, she felt chest pain accompanied with ECG changes consistent for ST-segment elevation myocardial infarction (STEMI). Urgent coronary angiography was undertaken, which reviled cloths causing total occlusion in 4 blood vessels, followed with thromboaspiration, but without successful reperfusion. Several hours later the patient developed rapid deterioration with letal ending. During the very short hospital course, blood sampling reviled presence of antiphospholipid antibodies.CONCLUSION: The acquired antiphospholipid syndrome is common condition in patients with systemic autoimmune diseases, but relatively rare in patients with systemic sclerosis. Never the less, we have to be aware of it when treating the patients with systemic sclerosis.

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