We have documented a unique instance of diabetic ketoacidosis (DKA)-induced stress-related cardiomyopathy (CMP) in a 46-yr-old Caucasian female with type I diabetes mellitus. In times of stress, tissues with high capacity for aerobic metabolism, like myocardium, can preferentially change their metabolic substrate to ketones. The myocyte has a decreased ability to metabolize glucose and free fatty acids in stress CMP. To the best of our knowledge this is the first report of stress CMP complicating DKA. A possible mechanism for the same is hypothesized.