Which of the following is a vascular complication of DKA/HHS?

• A. Myocardial infarction
• B. Cerebral edema
• C. Seizures
• D. Acute renal failure

Answer: (A)

Vascular complications in a severe hyperglycemic crisis mainly involve the heart. The combination of profound dehydration, increased catecholamine drive, acidosis, and electrolyte disturbances raises myocardial demand while potentially compromising coronary perfusion, making myocardial ischemia or infarction the primary vascular risk in DKA/HHS. Seizures and cerebral edema are neurologic problems arising from electrolyte shifts and osmotic changes, not vascular events. Acute renal failure tends to come from dehydration and prerenal hypoperfusion (and possible ATN), rather than a vascular event of the crisis itself. So the vascular complication to recognize in this context is myocardial infarction.