hello Welcome to HCM . She is having disorientation due to DKA. DKA causes acidosis which affects major body processes including the functioning of he heart. She must be started on iv fluids, and continuous insulin infusion for the DKA. Insulin dose can be adjusted according to the sugar levels which should be monitored hourly. A 2d echo must be done to correlate with the changes in theECG. If the ECG suggest heart muscle damage then she has to be started on blood thinner medications and nitrates (drugs dilating heart vessels). Once her sugar levels are stable, acidosis is corrected and urine has no ketones, she can undergo an angiography. Sometimes DKA can also cause decreased pumping function of the heart. Patients with long standing diabetes do not have chest pain while having a heart attack. . So once she is stable she must undergo an angiography. Angiography will suggest If there are any blockages in the heart. Further treatment can be decided on basis of the results of the angiography. Wishing her good health Regards.