Hyperkalemia-Induced Coronary Artery Spasm and Junctional Tachycardia in Diabetic Ketoacidosis Reversed with Insulin and Saline, A Case Report Volume 2 - Issue 5

Yasser Mohammed Hassanain Elsayed*

• Critical Care Unit, Fraskour Central Hospital, Egypt

Received: February 11, 2020;  Published: February 25, 2020

Corresponding author: Critical Care Unit, Fraskour Central Hospital, Damietta Health Affairs, Egyptian Ministry of Health (MOH), Damietta, Egypt

DOI: 10.32474/GJAPM.2020.02.000149

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Abstract

Rationale: Serum potassium concentration is usually elevated in the cases of diabetic ketoacidosis. Coronary artery spasm is recognized after the hematological chemical disturbance. Hyperkalemia is a rare cause of junctional tachycardia. Insulin decreases potassium levels in the blood by redistributing it into cells via increased sodium-potassium pump activity.

Patient concerns: A young housewife female patient presented to the emergency department with diabetic ketoacidosis, coronary artery spasm, and junctional tachycardia.

Diagnosis: Hyperkalemia-induced coronary artery spasm and junctional tachycardia in diabetic ketoacidosis.

Interventions: Electrocardiography, oxygenation, central venous pressure monitoring, and echocardiography.

Lessons: Electrolytes disturbance especially hyperkalemia is a significant serious metabolic problem in ketoacidosis. Hyperkalemia is a possible cause for both coronary artery spasm and junctional tachycardia in diabetic ketoacidosis.

Outcomes: Successful reversal of ketotic hyperkalemia-induced coronary artery spasm and junctional tachycardia with insulin and saline.

Keywords: Ketotic hyperkalemia; Induced junctional tachycardia; Insulin and saline; Diabetic ketoacidosis

Abbreviations: AVN: Atrioventricular node; CAS: Coronary artery spasm; DKA: Diabetic ketoacidosis; ECG: Electrocardiogram; ICU: Intensive care unit; SAN: Sinoatrial node

Abstract| Introduction| Case Presentation| Discussion| Recommendations| Conclusion| Conflicts of Interest| Acknowledgment| References|