Case report: A patient with cardiogenic shock and impaired fasting glucose

Cardiology Review® Online, January 2005, Volume 22, Issue 1

Case report: A patient with cardiogenic shock and impaired fasting glucose

A 63-year-old man with a history of hypertension was admitted to the coronary care unit with sudden-onset severe chest pain and the clinical signs of severe heart failure. The electrocardiogram showed marked ST-segment elevation in leads I, aVL, and V1 through V6; ST-segment depression in leads II and III; and ventricular fibrillation, suggesting acute anterior myocardial infarction. The patient’s systolic blood pressure was less than 90 mm Hg despite the fluid challenge associated with clinical signs of hypoperfusion, indicating cardiogenic shock. An emergency coronary angiogram showed a tight lesion (99% stenosis) in the left anterior descending coronary artery. Primary angioplasty was performed successfully with stent implantation. Following the procedure, the patient’s hemodynamic characteristics stabilized. Results of laboratory tests showed a peak plasma creatine kinase level of 9,756 UI/L and a mean fasting blood glucose level (taken on days 4 and 5) of 6.6 mmol/L, indicating impaired fasting glucose. n