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Hypoglycemia-Induced Angina Pectoris in a Patient with Diabetes Mellitus

Elia Duh, MD; and Mark Feinglos, MD
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From Duke University Medical Center, Durham, North Carolina. Requests for Reprints: Mark N. Feinglos, MD, Duke University Medical Center, Box 3921, Durham, NC 27710.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1994;121(12):945-946. doi:10.7326/0003-4819-121-12-199412150-00007
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The effects of diabetes mellitus on the prevalence of coronary artery disease and myocardial infarction are well known, as are the common precipitators of angina pectoris—physical exertion, emotional stress, and digestion of a large meal. We describe a patient with diabetes mellitus in whom angina pectoris was typically precipitated by hypoglycemia.

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Figure 1.
Hypoglycemia-induced electrocardiographic changes. Top.Middle.Bottom.

Baseline electrocardiogram obtained at admission. Electrocardiogram obtained during episode of hypoglycemia and chest pain. Electrocardiogram obtained 6 to 8 hours after resolution of chest pain.

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