Hyperkalemia

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Not an MI
Case description: A 58 year old man was admitted to the hospital with diabetic ketoacidosis. He had no previous cardiovascular history. He had been vomiting for 6 hours. On exam he was dehydrated and had a ketotic smell. Blood tests: pH of 7.2, Sodium 129 mmol/L and potassium 6.9 mmol/L, glucose 45 mmol/L. His admission ECG is shown below. The patient was referred for immediate coronary angiography. No coronary lesions were present. Subsequent ECG after correction of electrolytes is shown below.
Courtesy of: M. Meuwissen, MD, PhD, AMC, The Netherlands
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Admission ECG Right coronary artery
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Left coronary artery Follow-up ECG
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