Acute Myocardial Infarction in the Context of Diabetic Ketoacidosis: Pathophysiological Interactions, Clinical Manifestations, and Therapeutic Considerations

Abstract

Acute myocardial infarction (AMI) and diabetic ketoacidosis (DKA) are two critical conditions that can coexist with significant morbidity and mortality. AMI is a leading cause of cardiovascular death, while DKA is a severe complication of uncontrolled diabetes mellitus, characterized by hyperglycemia, metabolic acidosis, and ketonemia. The convergence of these conditions presents unique challenges in diagnosis and management, as the metabolic disturbances of DKA can exacerbate myocardial ischemia and contribute to poor clinical outcomes. This article aims to explore the pathophysiological interplay between AMI and DKA, focusing on their shared risk factors, metabolic derangements, and the impact of hyperglycemia and ketosis on myocardial oxygen supply and demand. Furthermore, we discuss the clinical presentation, diagnostic strategies, and therapeutic approaches tailored to this dual pathology. Early recognition and prompt intervention are crucial to improving prognosis in patients with coexisting AMI and DKA. Multidisciplinary management involving cardiologists, endocrinologists, and intensivists is essential to mitigate the adverse outcomes of this complex clinical scenario.