A PATIENT WITH DROWSINESS AND CARDIAC ARRHYTHMIA
Vivek Podder1, Boudhayan Das Munshi 2
1BMJ Elective Student, (February-March, 2017), Department of Medicine, IQ City Medical College and Narayana Multispeciality Hospital Durgapur, WB, India.
2Consultant Diabetologist and Former Assistant Professor, Department of General Medicine, IQ City Medical College and Narayana Multispeciality Hospital Durgapur, WB, India.
Abstract: Sick sinus syndrome (SSS) can occur due to an intrinsic defect in the sinus node or extrinsic reversible etiologies. Hyperkalemia, which is a common occurrence in the emergency care or intensive care setting, has rarely been attributed to as reversible cause of SSS. Our case describes the potential reversible association between hyperkalemia and the development of SSS. A 65-year-old elderly patient with recent cerebrovascular accident was admitted to the hospital with sudden-onset drowsiness. He had a poor Glasgow Coma Scale (GCS) score. His electrocardiogram revealed an alternating slow and fast rhythms (bradycardia-tachycardia) with right bundle branch block and left axis deviation which coincided with new-onset of hyperkalemia following sepsis-induced AKI. The patient was successfully treated for hyperkalemia and sepsis which concurrently reversed his characteristic ECG findings. Our case report adds to the literature that several reversible causes are found to be associated with the development of SSS, where manifestation of SSS can be attributed to the presence of hyperkalemia and correction of hyperkalemia can reverse the sinus node dysfunction
Keywords: Sick sinus syndrome; Hyperkalemia; Extrinsic cause;