Infection and DKA, then sudden dyspnea while in the ED

To learn more about Occlusion MI, join us in thisFree Webinar on November 27 12 noon US Central Time:Sign up at this link: https://zoom.us/webinar/register/2216945975176/WN_7HuMRHNxREKifGgQvy70lg#/registrationInfection and DKA, then sudden dyspnea while in the EDA 63 year old male with a PMH of CAD and peripheral vascular disease from type 1 DM presented to clinic and was found to have a very high blood sugar and so was sent to the emergency department.Patient stated that he has had glucose over 400 even though he has not missed any doses of insulin.  He also endorses fatigue, upset stomach, frequent urination, increased thirst, and decreased apatite over the past 2 days. Pulse was 115, BP 140/65, and afebrileHe was found to have cellulitis and to be in diabetic ketoacidosis, with bicarb of 14, pH of 2.27, glucose of 381, anion gap of 18, and lactate of 2.2 mEq/L.He was treated for infection and DKA and admission to hospital was planned.While in the ED, patient developed acute dyspnea while at rest, initially not associated with chest pain. He later developed mild continuous chest pain, that he describes as the sensation of someone standing on his chest. This ECG was recorded: What do you think?There is widespread ST depression.  This is ischemic ST depression, and could be due to increasing tachycardia, with a heart rate over 130, but that is unlikely given that the patient is now complaining of crushing chest pain and that there was tachycardia...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs