title: Acute myocardial infarction in a 12-year-old as a complication of hyperosmolar diabetic ketoacidosis.
abstract: OBJECTIVE: This report describes the evolution of an acute myocardial infarction in a 12-yr-old male with severe hyperosmolarity secondary to diabetic ketoacidosis. DESIGN: Case report. SETTING: Intensive care unit of a university teaching hospital. Patient: A 12-yr-old male with new-onset diabetic ketoacidosis and an abnormal electrocardiogram. MEASUREMENTS AND MAIN RESULTS: The evolution of an acute myocardial infarction in this patient is described. This includes serial electrocardiographic, echocardiographic, and enzymatic changes. Early recognition of this complication of diabetic ketoacidosis prompted immediate initiation of antithrombotic therapy and possible prevention of infarct extension. CONCLUSION: This report demonstrates the need for accurate electrocardiographic monitoring in these patients, both for arrhythmias as well as ischemic changes and the potential for myocardial injury caused by hyperosmolarity.
authors.affiliation: Division of Cardiology, Childrens Hospital Los Angeles, University of Southern California, Los Angeles, CA.
authors.forename: Anjan S.
authors.initials: AS
authors.lastname: Batra
authors.forename: Ruben J.
authors.initials: RJ
authors.lastname: Acherman
authors.forename: Pierre
authors.initials: P
authors.lastname: Wong
authors.forename: Michael J.
authors.initials: MJ
authors.lastname: Silka