MYOCARDIAL INJURY IN CHILDREN WITH TYPE 1 DIABETES MELLITUS PRESENTING WITH DIABETIC KETOACIDOSIS

Abstract

SUMMARY C hildren diagnosed with T1DM have a high risk of early subclinical and clinical CVD. Although intervention data are lacking, the American heart association categorizes children with type 1 diabetes in the highest tier for cardiovascular risk. Myocardial damage in children may be clinically occult in a variety of stressful settings. Nevertheless, biochemical markers have not been routinely used in children at risk for myocardial damage due to a lack of sufficient specificity to unambiguously guide patient management. Speckle Tracking Echocardiography helps in assessment of cardiac mechanics in the three spatial planes: longitudinal, circumferential, and radial. Hence, enabling early detection of changes in heart performance and, as a consequence, promoting more effective therapeutic approaches. Longitudinal strain seems to be the earliest to be affected by ischemia, as the subendocardial fibres are the first to suffer the effects of perfusion abnormalities. Hemodynamic monitoring is the cornerstone of critical care. One of the primary goals of hemodynamic monitoring is to alert the physician to impending cardiovascular crisis before organ or tissue injury ensues. Children with T1DM presenting with DKA are at risk but rarely screened for myocardial injury. Frequency of such injury among this population is unknown.