Highlights a potential link between severe metabolic derangement (DKA) and the development of a reversible cardiomyopathy that may differ mechanistically from typical stress cardiomyopathy.
Metabolic DKA may trigger mid-segment cardiomyopathy; single case leaves open need for prospective validation before clinical consideration.
Stress cardiomyopathy is a reversible syndrome that is usually triggered by emotional and physical stressors. We describe a patient who was admitted with diabetic ketoacidosis (DKA) and found to have metabolic-induced cardiomyopathy. The echocardiogram primarily revealed hypokinesis in the mid-segments, and left heart catheterization showed angiographically normal-appearing coronary vessels. The patient did not have significant emotional or physical stressors but did have a significant metabolic derangement. We suspect that the underlying mechanism of DKA-induced cardiomyopathy may differ from that of stress cardiomyopathy. Therefore, further observation and investigation are warranted.
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Lei Gao (2025) studied this question.
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