Myocardial infarction has rarely been documented as a consequence of hypoglycaemia (Fisher and Frier, 1993). In a series of non-diabetic patients with schizophrenia who were treated with hypoglycaemic shock therapy in the 1930s, 12 of 90 deaths were ascribed to cardiac causes, with the majority of deaths being caused by cerebral damage. It should be emphasised that this long-abandoned form of treatment of psychiatric disease necessitated prolonged and profound hypoglycaemia.
Only a few cases have been published of myocardial infarction and hypoglycaemia in diabetic patients (Purucker et al., 2000; Chang et al., 2007). This possible association is very difficult to establish because of the problems described above. In addition, the release of stress hormones such as glucagon, cortisol and epinephrine will raise blood glucose and make the contribution of preceding hypoglycaemia almost impossible to confirm.
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