Can anyone shed some light on this case I had: a 17 year old male with central chest pain of sudden onset, breathing difficulties, flushed face, GCS 15, had been vomiting, BM 22.6 mmol, insulin dependent diabetic. When we carried out a 12 lead ecg we couldn't believe our eyes when the monitor suggested an extensive MI. We were not convinced and suspected it could be diabetic ketoacidosis. This was then confirmed on arrival to A&E. I know DKA often presents with abdominal pain, but never thought it could, at least to some extent, mimic an MI. I would be most grateful if someone could explain this to me and perhaps point out relevant online literature.