Summary and Conclusions
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1.
A case of acute pulmonary edema occurring during insulin shock treatment is presented.
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2.
Electrocardiographic tracings resembling those seen in coronary occlusion are shown.
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3.
In cases of pulmonary edema during insulin treatment, electrocardiographic studies should be made. These may lead to a more adequate understanding of the myocardial and pulmonary changes, and the relation between them during hypoglycemia.
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4.
Electrocardiographic changes produced during insulin shock treatment may indicate disturbance of the cardiac conduction system rather than disturance of the myocardium proper or of the coronary vessels. The latter two are suspected but not definitely proved to be involved.
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5.
The presence of mild myocardial disease need not necessarily preclude treatment, but should dictate extreme caution.
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Gralnick, A. Pulmonary edema and electrocardiographic findings resembling coronary occlusion in insulin treatment. Psych Quar 18, 650–659 (1944). https://doi.org/10.1007/BF01569067
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DOI: https://doi.org/10.1007/BF01569067