Lactic acidosis from metformin in Emergency Room

Lactic acidosis is a metabolic alteration that can evolve in any reduced tissue hypoxic state in case of hepatic dysfunction, pulmonary embolism, and acute myocardial infarction. Signs and symptoms of acidosis are not always easily noticeable. In fact acidosis can be asymptomatic or can be accompanied by vague asthenia, nausea or vomiting. A distinctive symptom of acidosis is hyperpnoea, an increased depth followed by an increased frequency of breathing. Severe acidosis can determine cardio circulatory shock due to a reduced myocardial contractility or progressive sensory alteration.