Podcast #282: EKG Changes in DKA

Author: Dave Rosenberg, M.D.

Educational Pearls

• EKG changes that can be seen in DKA include ST elevation and peaked T-waves secondary to derangements in K levels.
• In DKA, serum K is high, but total body K is low, which can cause said EKG abnormalities.
• Many things cause ST elevation besides MI, so think beyond STEMI.
• When someone in in DKA, think about the "Three I's" for underlying cause: (not taking) insulin, ischemia, infection.

References: Nageswara Rao Chava. ECG in Diabetic Ketoacidosis. Arch Intern Med. 1984;144(12):2379–2380. doi:10.1001/archinte.1984.00350220101022