[Primary aldosteronism with ventricular fibrillation: a case report]

Area of Science:

• Cardiology
• Endocrinology
• Medical Diagnostics

Background:

• Primary aldosteronism can lead to severe electrolyte imbalances, including hypokalemia.
• Hypokalemia is a known risk factor for cardiac arrhythmias, such as ventricular fibrillation (VF).
• QT prolongation is an electrocardiographic finding associated with electrolyte disturbances and arrhythmia risk.

Observation:

• A 60-year-old female presented with syncope and cardiopulmonary arrest (ventricular fibrillation).
• Initial management included defibrillation, potassium administration, and lidocaine, but ventricular fibrillation persisted.
• The patient required temporary overdrive pacing due to refractory ventricular fibrillation and was diagnosed with primary aldosteronism.

Findings:

• Laboratory and imaging confirmed primary aldosteronism as the underlying cause.
• Implantation of a cardioverter-defibrillator was necessary due to uncontrollable ventricular fibrillation.
• Laparoscopic adrenalectomy resolved the primary aldosteronism, leading to normalized serum potassium levels without medication.

Implications:

• This case highlights the critical link between primary aldosteronism, severe hypokalemia, and life-threatening ventricular fibrillation.
• Early diagnosis and management of primary aldosteronism are crucial for preventing cardiac events.
• Surgical intervention (adrenalectomy) can effectively cure primary aldosteronism and its associated cardiac complications.