Myocardial infarction in a 23-year old patient with 16 years history of type 1 diabetes

Abstract

The case presented is a 23-year old female patient with type 1 diabetes for 16-years. The clinical course was complicated by proliferative retinopathy, neuropathy and nephropathy at the stage of renal insufficiency. The patient was admitted to the hospital due to increasing dyspnoe at rest. Before admission there were no symptoms of heart disease. Clinical examination and X-ray showed signs of left ventricular failure. Based on the history, clinical examination and additional procedures (laboratory findings, X-ray, echocardiography) she was diagnosed to have recently suffered from a myocardial infarction. Coronarography revealed multiple and diffused changes in the coronary arteries. The patient was disqualified from any cardiac surgical intervention due to chronic renal insufficiency. Because of this, she was also disqualified from heart transplantation. At follow-up we did not observe any clinical symptoms of coronary disease. Worsening of metabolic control of diabetes tended to increase the symptoms of heart failure.