Open AccessA 78-year-old male with inferior ST-segment elevation on electrocardiogram, diabetic ketoacidosis and acute pancreatitis
Author(s) -
Jamie Sin-Ying Ho,
Bryan Mui,
ChingHui Sia,
Andie Hartanto Djohan,
Shao-Feng Mok,
Mark Y. Chan,
Anand Ambhore
Publication year - 2020
Publication title -
cardiovascular endocrinology and metabolism
Language(s) - English
Resource type - Journals
ISSN - 2574-0954
DOI - 10.1097/xce.0000000000000205
Subject(s) - medicine , diabetic ketoacidosis , acute pancreatitis , diabetes mellitus , pancreatitis , ketoacidosis , st elevation , emergency department , cardiology , troponin , cardiac catheterization , shock (circulatory) , myocardial infarction , endocrinology , type 1 diabetes , psychiatry
A 78-year-old male presented with shortness of breath, metabolic acidosis, severe hyperglycaemia and ketonemia. Inferior ST-elevation was present on 12-lead ECG with raised troponin I, but coronary arteries were normal on emergency cardiac catheterization. Despite no previous history of diabetes mellitus and normal HbA1c levels 7 months prior, diabetic ketoacidosis (DKA) was diagnosed, complicated by subsequent shock. The underlying cause was acute pancreatic disease, supported by elevated pancreatic enzyme levels and a history of chronic heavy alcohol use. There are no previous reports, to our knowledge, of patients with acute pancreatitis presenting to the ED with secondary DKA mimicking STEMI.