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04:01
Point of Care Transcranial Color-Coded Duplex Ultrasound of the Middle Cerebral Artery
Published on: August 9, 2024
Brainstem infarct presenting as torsades de pointes.
Sivakumar Ardhanari1, Balashankar Gomathi S, L Anita
1Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai, Tamil Nadu.
Indian Heart Journal
|July 20, 2010
Summary
Severe alkalosis can cause hypokalemia, leading to dangerous heart rhythms like torsades de pointes. This case highlights central neurogenic hyperventilation from a brainstem infarct causing refractory ventricular tachyarrhythmia due to secondary hypokalemia.
Area of Science:
- Neurology
- Cardiology
- Critical Care Medicine
Background:
- Severe alkalosis is known to cause hypokalemia, a condition that can lead to cardiac arrhythmias.
- Hypokalemia can prolong the QT interval, increasing the risk of potentially fatal ventricular tachyarrhythmias such as torsades de pointes.
Observation:
- This report details a rare case of central neurogenic hyperventilation.
- The hyperventilation stemmed from a brainstem infarct.
- The patient presented with refractory ventricular tachyarrhythmia secondary to hypokalemia.
Findings:
- Central neurogenic hyperventilation can precipitate severe alkalosis.
- This alkalosis, in turn, can lead to profound hypokalemia.
- The resulting hypokalemia was the primary driver of the refractory ventricular tachyarrhythmia.
Implications:
- This case underscores the critical link between respiratory and metabolic disturbances in neurological injury.
- Recognizing central neurogenic hyperventilation is crucial for managing electrolyte imbalances and cardiac complications.
- Early diagnosis and management of hypokalemia are vital in patients with brainstem infarcts to prevent life-threatening arrhythmias.
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