Severe Diabetic Ketoacidosis Associated With Acute Myocardial Necrosis

Abstract

Henry RR: Skeletal muscle protein-tyrosine phosphatase activity and tyrosine phosphatase 1B protein content are associated with insulin action and resistance.

Elevated Troponin I Levels in Diabetic Ketoacidosis Without Obstructive Coronary Artery Disease

“…These clinical conditions usually cause myocardial necrosis owing to a supply–demand mismatch or direct myocardial toxicity. Diabetic ketoacidosis (DKA) is another condition that can lead to myocardial necrosis in the absence of coronary artery disease (CAD) and has been the subject of previous case reports [1, 2], case series [3], and retrospective reviews [4, 5]. The present case report contributes to the reported data regarding this finding, which has prognostic implications.…”

Chest pain in emergency department: A diagnosis of diabetic ketoacidosis must be ruled out

“…Theories include severe acid-base and electrolyte disturbances triggered coronary spasms and dehydration, low cardiac output, increased blood viscosity, impaired blood flow, increased platelet aggregation, increased red blood cell rigidity and hemostatic changes triggering the development of thrombosis [10]. DKA results in a prothrombotic state and activation of the vascular endothelium, which in turn predispose to cerebrovascular accidents or myocardial necrosis [3].…”

“…The non-typical symptoms have been reported such as DKA associated with pericarditis and myocardial . However, the mechanism in the development of myocardial necrosis remains unclear [2][3][4].…”

Beeinträchtigung des kardialen autonomen Nervensystems und Arrhythmie-Inzidenz bei schwerer Hyperglykämie

“…Daneben war auffällig, dass sich die arrhythmischen Episoden nach stärkerer Hyperglykä-mie in der Mehrzahl erst mit einiger Verzögerung einstellten (< 600 mg/dl vs. > 600 mg/dl: p = 0,022), d.h. nachdem die Blutglucosespiegel wieder stark gesunken waren. Auch dies ist bekannt (initial 1350 mg/dl, gehäuft VEs an Tag 3) [67].…”

“…Dennoch waren einige Enzymaktivitäten und Stoffwechselprodukte, die mit einer Schä-digung von Zellstrukturen bzw. Elektrolytverschiebungen verbunden sind, in Abhängigkeit vom Glucosespiegel erhöht [67,81]. Dies betrifft u.a.…”