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Annals of Clinical Biochemistry

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This version was published on 1 May 2009
Ann Clin Biochem 2009;46:257-260
doi:10.1258/acb.2009.008237
© 2009 Association for Clinical Biochemistry

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Case Reports

Stress cardiomyopathy – a unique presentation of diabetic ketoacidosis

Sudip Nanda1, Santo Longo2, Surya Prakash Bhatt1, John Pamula1, Shree Gopal Sharma3 and Thompson H Dale4


1 Department of Internal Medicine; 2 Department of Pathology, St. Luke's Hospital, Bethlehem, PA; 3 Department of Pathology, University of Arkansas, Little Rock, AR; 4 Department of Cardiology, St. Luke's Hospital, Bethlehem, PA 18015, USA


Corresponding author: Sudip Nanda. Email: sudipnanda2000{at}yahoo.com

We have documented a unique instance of diabetic ketoacidosis (DKA)-induced stress-related cardiomyopathy (CMP) in a 46-yr-old Caucasian female with type I diabetes mellitus. In times of stress, tissues with high capacity for aerobic metabolism, like myocardium, can preferentially change their metabolic substrate to ketones. The myocyte has a decreased ability to metabolize glucose and free fatty acids in stress CMP. To the best of our knowledge this is the first report of stress CMP complicating DKA. A possible mechanism for the same is hypothesized.


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