Journal of Diabetes and Its Complications
Volume 19, Issue 6 , Pages 361-363, November 2005

Myocardial injury with biomarker elevation in diabetic ketoacidosis

  • Niels Moller

      Affiliations

    • Medical Department M (Endocrinology and Diabetes), Aarhus University Hospital, Aarhus DK-8000, Denmark
    • Corresponding Author InformationCorresponding author. Medical Research Laboratories, Medical Department M, Aarhus University Hospital, Aarhus C DK-8000, Denmark. Tel.: +45 89 49 21 65; fax: +45 89 49 20 10
    • ,
  • Anne-Catherine H. Foss

      Affiliations

    • Medical Department M (Endocrinology and Diabetes), Aarhus University Hospital, Aarhus DK-8000, Denmark
    • ,
  • Claus H. Gravholt

      Affiliations

    • Medical Department M (Endocrinology and Diabetes), Aarhus University Hospital, Aarhus DK-8000, Denmark
    • ,
  • Ulrik M. Mortensen

      Affiliations

    • Department of Cardiology B, Aarhus University Hospital, Aarhus DK-8000, Denmark
    • ,
  • Steen Hvitfeldt Poulsen

      Affiliations

    • Department of Cardiology B, Aarhus University Hospital, Aarhus DK-8000, Denmark
    • ,
  • Carl E. Mogensen

      Affiliations

    • Medical Department M (Endocrinology and Diabetes), Aarhus University Hospital, Aarhus DK-8000, Denmark

Received 25 January 2005; received in revised form 8 April 2005; accepted 22 April 2005.

Abstract 

We report of two patients with severe ketoacidosis, minute elevations of myocardial biomarkers (troponin T and CK-MB) and initial ECG changes compatible with myocardial infarction (MI). All successive investigations, including coronary arteriography, were normal, and the patients recovered fully without further evidence of ischemic heart disease. We suggest that acidosis and very high levels of free fatty acids could cause membrane instability and biomarker leakage. Regardless of the pathogenesis, these two case stories suggest that nonspecific myocardial injury may occur in severe diabetic ketoacidosis and that the presence of minute biomarker elevation and ECG changes does not necessarily signify MI.

Keywords: Diabetic ketoacidosis, Biomarkers, ECG, Myocardial infarction, Free fatty acids

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PII: S1056-8727(05)00042-5

doi:10.1016/j.jdiacomp.2005.04.003

Journal of Diabetes and Its Complications
Volume 19, Issue 6 , Pages 361-363, November 2005

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