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A 38-year-old man presented to the emergency department with nausea, vomiting, and epigastric pain. The patient had type 1 diabetes mellitus and was being treated with insulin. He was also taking lisinopril for the treatment of hypertension.
The initial electrocardiogram (Panel A) revealed sinus tachycardia and ST-segment elevation in leads V1 to V3 findings highly suggestive of acute anteroseptal myocardial infarction. Peaked T waves were noted in leads II, III, aVF, and V3 to V6.
The serum glucose concentration was 839 mg per deciliter (46.6 mmol per liter), the arterial blood pH was 7.21, and the serum potassium . . . [Full Text of this Article] |