Key result
ST-segment elevations associated with diabetic ketoacidosis and hyperkalemia resolved completely following a minor 6.3% decrease in serum potassium levels, without significant changes in pH.
Why the study?
Diabetic ketoacidosis with hyperkalemia can lead to ST-segment elevations on ECG, and previous literature theorizes that significant improvements in potassium levels are required to resolve this pseudo-infarct pattern.
Case Report (n=1)
ST-segment elevations mimicking acute myocardial infarction in the setting of diabetic ketoacidosis and hyperkalemia can resolve with even minor improvements in serum potassium levels.
Caution advised before assuming ACS in DKA-related ST elevations; case report leaves open need for prospective validation.
Diabetic ketoacidosis (DKA) with resulting hyperkalemia can lead to ST-segment elevations on electrocardiogram (ECG). Previous publications theorize that significant improvements in patient potassium levels lead to the resolution of this rare phenomenon, also known as "pseudo-infarct" pattern. The authors provide a unique case along with a literature review of DKA-associated ST-segment elevations. This specific case distinctively demonstrates the resolution of the pseudo-infarct pattern in the setting of minor improvements in serum potassium and continued acidosis.
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Wray et al. (2020) conducted a case report in Diabetic ketoacidosis with hyperkalemia (n=1). Insulin and fluid resuscitation was evaluated on Resolution of ST-segment elevation. ST-segment elevations associated with diabetic ketoacidosis and hyperkalemia resolved completely following a minor 6.3% decrease in serum potassium levels, without significant changes in pH.
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