REPEATED CARDIAC ARRESTS IN A PATIENT WITH HYPOKALEMIC PERIODIC PARALYSIS AND TYPE 2 DIABETES MELLITUS
Abstract:
We present the case of a 42-year-old woman, brought into the emergency unit for severe muscle weakness predominantly in the lower limbs and cardiac arrhythmia, complicated with cardiac arrest responsive to resuscitation. Laboratory tests at admission revealed extremely low levels of potassium, severe respiratory acidosis and hyperglycemia. Four years prior this presentation, she was brought to the emergency room for shortness of breath and cardiac arrhythmia, flaccid tetraparesis after an episode of digestive infection. Soon after admission in the cardiology department, she developed sustained ventricular tachycardia, followed by asystole, but responsive to resuscitation manoeuvres. Potassium level was low and serum glucose level was increased. In both situations, the patient’s condition improved significantly after rebalancing the electrolytes and acid-base metabolism. It is to be mentioned that both episodes occurred after physical effort, consistent with a positive diagnosis of sporadic hypokalemic periodic paralysis. Associated type 2 diabetes mellitus raises the question of therapy management, knowing that the potassium homeostasis is modified by hyperglycemia and its complications, but also by insulin therapy. We consider this case as being particular by the nature of the cardiac events and pathological associations, in literature, such cases being rarely reported.
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