Hyperosmolar hyperglycemic state induced myocardial infarction: a complex conjunction of chronic and acute complications with diabetes mellitus.
Diabetes mellitus is associated with acute and chronic complications that cause major morbidity and significant mortality. We report a 69-year-old man with unknown diabetes, presenting vague epigastric discomfort, polyuria, polydipsia, fatigue, anorexia, weight loss over 1 week and severe chest pain for 1 day. Electrocardiogram revealed ST-segment elevation in lead V1 through V6. Blood chemistry examination revealed a creatine kinase level of 2053 U/l, creatine kinase-MB (CK-MB) level 43 U/l, a troponin I level of 23.21 ng/ml, a blood sugar level of 957 mg/dl, blood osmolality of 324 mosm/kg and no ketonemia. The patient was diagnosed as hyperosmolar hyperglycemic state accompanying acute anterior wall ST-segment elevation myocardial infarction on unknown diabetes mellitus. Aggressive therapy failed to ameliorate the patient's clinical outcome.
Lin
Pao-Ying
PY
Department of Internal Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, Hsintien, Taipei Hsien, Taiwan.
Wang
Cheng-Yi
CY
Wang
Jen-Yu
JY
D000368:Aged; D001660:Biliary Tract Diseases / Q000150:complications; D048909:Diabetes Complications / Q000175:diagnosis*; D004927:Escherichia coli Infections / Q000150:complications; D017809:Fatal Outcome; D006801:Humans; D006943:Hyperglycemia / Q000150:complications*; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology*