Stress-induced or Takotsubo cardiomyopathy (TCM) is a phenomenon that typically occurs in postmenopausal women in the setting of acute emotional or medical stressors. It typically causes reversible akinesis of the heart apex with opposite hyperdynamic basal segments. An electrocardiogram (ECG) would show ischemic ST elevation in anterior leads in >90% of cases with elevated troponin, yet coronary angiography rules out occlusive disease. Takotsubo cardiomyopathy in the setting of diabetic ketoacidosis (DKA) is a rare phenomenon that has been attributed to severe acidosis. Here, we report the case of a 37year-old male with severe DKA that was complicated by stress cardiomyopathy and progressed to cardiogenic shock.
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