Perfusion and wall motion abnormalities in a patient with diabetic ketoacidosis
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A 54-year-old Caucasian postmenopausal woman with type II diabetes mellitus, on insulin therapy for 5 years, and hypercholesterolemia presented to the emergency department with complaints of nausea, diarrhea, and vomiting for 1 day. On examination, she was short of breath, her heart rate was 130 beats/minute and regular, blood pressure was 140/78 mm Hg, and respiratory rate was 35 breaths/minute. Cardiac examination was unremarkable and the lungs were clear to auscultation. The laboratory results were consistent with diabetic ketoacidosis (DKA): arterial blood gas pH = 7.00, anion gap = 28, serum blood glucose = 462 mg/dL, serum acetone positive and urine positive for ketones. She had no prior history of coronary artery disease and no difficulty in controlling her blood glucose levels until one day prior to admission. In reviewing her social history, she was content with her work and family life, with no history of drug or alcohol use and no emotional stressors. ECG sh ...
- Tsuchihashi K, Ueshima K, Uchida T, Oh-mura N, Kimura K, Owa M, et al. Transient left ventricular apical ballooning without coronary artery stenosis: A novel heart syndrome mimicking acute myocardial infarction angina pectoris-myocardial infarction investigations in Japan. J Am Coll Cardiol 2001;38:11-8. CrossRef
- Sharkey SW, Lesser JR, Zenovich AG, Maron MS, Lindberg J, Longe TF, et al. Acute and reversible cardiomyopathy provoked by stress in women from the United States. Circulation 2005;111:472-9. CrossRef
- Wittstein IS, Thiemann DR, Lima JA, Baughman KL, Schulman SP, Gerstenblith G, et al. Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med 2005;352:539-48. CrossRef
- Kono T, Morita H, Kuroiwa T, Onaka H, Takatsuka H, Fujiwara A. Left ventricular wall motion abnormalities in patients with subarachnoid hemorrhage: Neurogenic stunned myocardium. J Am Coll Cardiol 1994;24:636-40. CrossRef
- Ohtsuka T, Hamada M, Kodama K, Sasaki O, Suzuki M, Hara Y, et al. Images in cardiovascular medicine. Neurogenic stunned myocardium. Circulation 2000;101:2122-4.
- Shaw TR, Rafferty P, Tait GW. Transient shock and myocardial impairment caused by phaeochromocytoma crisis. Br Heart J 1987;57:194-8. CrossRef
- Bybee KA, Kara T, Prasad A, Lerman A, Barsness GW, Wright RS, et al. Systematic review: Transient left ventricular apical ballooning: A syndrome that mimics ST-segment elevation myocardial infarction. Ann Intern Med 2004;141:858-65.
- Kume T, Akasaka T, Kawamoto T, Yoshitani H, Watanabe N, Neishi Y, et al. Assessment of coronary microcirculation in patients with Takotsubo-like left ventricular dysfunction. Circ J 2005;69:934-9. CrossRef
- Dorfman T, Aqel R, Allred J, Woodham R, Iskandrian AE. Takotsubo cardiomyopathy induced by treadmill exercise testing: An insight into the pathophysiology of transient left ventricular apical (or midventricular) ballooning in the absence of obstructive coronary artery disease. J Am Coll Cardiol 2007;49:1223-5. CrossRef
- Banihashemi MR, Khan IA. Acute stress-induced cardiomyopathy: A brief observation. Int J Cardiol 2008 (in press). doi:10.1016/j.ijcard.2007.12.105.
- Lee YP, Poh KK, Lee CH, Tan HC, Razak A, Chia BL, et al. Diverse clinical spectrum of stress-induced cardiomyopathy. Int J Cardiol 2008 (in press). doi:10.1016/j.ijcard.2007.11.039.
- Burg MM, Jain D, Soufer R, Kerns RD, Zaret BL. Role of behavioral and psychological factors in mental stress-induced silent left ventricular dysfunction in coronary artery disease. J Am Coll Cardiol 1993;22:440-8.
- Jain D, Burg M, Soufer R, Zaret BL. Prognostic implications of mental stress-induced silent left ventricular dysfunction in patients with stable angina pectoris. Am J Cardiol 1995;76:31-5. CrossRef
- Perfusion and wall motion abnormalities in a patient with diabetic ketoacidosis
Journal of Nuclear Cardiology
Volume 16, Issue 2 , pp 316-320
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