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一例糖尿病酮症酸中毒诱发的心肌病

A Case of Diabetic Ketoacidosis-Induced Cardiomyopathy.

作者信息

Crosby Chelsea, Gao Lei

机构信息

Cardiology, Virginia Mason Franciscan Health Heart and Vascular, Burien, USA.

出版信息

Cureus. 2025 May 4;17(5):e83472. doi: 10.7759/cureus.83472. eCollection 2025 May.

DOI:10.7759/cureus.83472
PMID:40470400
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12134704/
Abstract

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.

摘要

应激性心肌病是一种通常由情绪和身体应激源引发的可逆综合征。我们描述了一名因糖尿病酮症酸中毒（DKA）入院的患者，发现其患有代谢性心肌病。超声心动图主要显示中段运动减弱，左心导管检查显示冠状动脉血管造影外观正常。该患者没有明显的情绪或身体应激源，但确实存在明显的代谢紊乱。我们怀疑DKA诱发的心肌病的潜在机制可能与应激性心肌病不同。因此，有必要进行进一步的观察和研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82f1/12134704/61cb5cdfa1cc/cureus-0017-00000083472-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82f1/12134704/b1a79a34e03f/cureus-0017-00000083472-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82f1/12134704/7bd8fb414bec/cureus-0017-00000083472-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82f1/12134704/227b8c2b3528/cureus-0017-00000083472-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82f1/12134704/7817497865da/cureus-0017-00000083472-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82f1/12134704/61cb5cdfa1cc/cureus-0017-00000083472-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82f1/12134704/b1a79a34e03f/cureus-0017-00000083472-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82f1/12134704/7bd8fb414bec/cureus-0017-00000083472-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82f1/12134704/227b8c2b3528/cureus-0017-00000083472-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82f1/12134704/7817497865da/cureus-0017-00000083472-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82f1/12134704/61cb5cdfa1cc/cureus-0017-00000083472-i05.jpg

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本文引用的文献

1
A Case Of Takotsubo Syndrome Precipitated By Diabetic Ketoacidosis.糖尿病酮症酸中毒诱发的 Takotsubo 综合征 1 例。
J Ayub Med Coll Abbottabad. 2023 Oct-Dec;35(4):675-679. doi: 10.55519/JAMC-04-12307.
2
Cardiogenic shock secondary to stress-induced cardiomyopathy precipitated by severe diabetic ketoacidosis.严重糖尿病酮症酸中毒诱发应激性心肌病继发的心源性休克。
Oxf Med Case Reports. 2023 Jan 18;2023(1):omac156. doi: 10.1093/omcr/omac156. eCollection 2023 Jan.
3
Diabetic Ketoacidosis-Induced Cardiomyopathy and Reversible Dialysis-Dependent Renal Failure With Successful Outcome: A Report of a Rare Case.
糖尿病酮症酸中毒诱发的心肌病及可逆性依赖透析的肾衰竭并成功治愈：1例罕见病例报告
Cureus. 2022 Nov 20;14(11):e31711. doi: 10.7759/cureus.31711. eCollection 2022 Nov.
4
Autoimmune polyendocrine syndrome II presenting paradoxically as Takotsubo cardiomyopathy: a case report and reappraisal of pathophysiology.自身免疫性多内分泌腺综合征II反常地表现为应激性心肌病：一例病例报告及病理生理学的重新评估
Egypt Heart J. 2022 Dec 13;74(1):82. doi: 10.1186/s43044-022-00321-6.
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An Update on the Incidence and Burden of Diabetic Ketoacidosis in the U.S.美国糖尿病酮症酸中毒发病率及负担的最新情况
Diabetes Care. 2020 Dec;43(12):e196-e197. doi: 10.2337/dc20-1258. Epub 2020 Oct 13.
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Management of Diabetic Ketoacidosis in Adults: A Narrative Review.成人糖尿病酮症酸中毒的管理：一篇叙述性综述
Saudi J Med Med Sci. 2020 Sep-Dec;8(3):165-173. doi: 10.4103/sjmms.sjmms_478_19. Epub 2020 Aug 20.
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Association of Endocrine Conditions With Takotsubo Cardiomyopathy: A Comprehensive Review.内分泌疾病与应激性心肌病的关联：一项综述
J Am Heart Assoc. 2018 Oct 2;7(19):e009003. doi: 10.1161/JAHA.118.009003.
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Stress Cardiomyopathy Diagnosis and Treatment: JACC State-of-the-Art Review.应激性心肌病的诊断与治疗：美国心脏病学会心血管造影及介入治疗学会最新临床观点。
J Am Coll Cardiol. 2018 Oct 16;72(16):1955-1971. doi: 10.1016/j.jacc.2018.07.072.
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