1例糖尿病酮症酸中毒恢复期患者与点扭转相关的心脏骤停

Jinmo Kim, Ju Yeop Lee, W. Yoo, M. Lee, Hyun-Kyung Chung
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摘要

糖尿病酮症酸中毒(DKA)是与严重高血糖相关的急性并发症。虽然DKA的死亡率在适当的治疗下很低,但一些并发症可能导致临床病程恶化。在这里,我们报告一例23岁的DKA患者,他患有一种罕见但血流动力学不稳定的心律失常,多态性室性心动过速伴QT间期延长,或称为扭转角。在DKA的恢复阶段,突然发生了3次尖角畸形发作,并通过立即除颤恢复。该患者没有结构性心脏病或遗传易感性。据我们所知,这是第一例成人DKA患者在纠正酮症后并发与点扭转相关的QT延长的报道。为了管理DKA,可能需要更多地关注QT间期的变化以及扭转角的危险因素。
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Cardiac Arrest Related to Torsades de Pointes in a Patient Recovering from Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is an acute complication related to severe hyperglycemia. While the mortality rate for DKA is low with appropriate therapy, several complications may lead to deterioration of the clinical course. Here, we report a case of a 23-year-old patient with DKA who suffered from a rare but hemodynamically unstable cardiac arrhythmia, polymorphic ventricular tachycardia with prolonged QT interval, or Torsades de Pointes. During the recovery phase of DKA, three episodes of Torsades de Pointes suddenly occurred, and were recovered by immediate defibrillation. The patient did not have structural heart disease or a genetic predisposition. To the best of our knowledge, this is the first report of an adult with DKA complicated with QT prolongation related to Torsades de Points after correction of ketosis. To manage DKA, more attention may be needed on changes in the QT interval as well as risk factors for Torsades de Points.
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