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Cardiac arrest due to lymphocytic colitis: a case report
Kristian A Groth1, Jens Kelsen, Bo Løfgren
1Department of Cardiology, Aarhus University Hospital, Skejby, Brendstrupgaardsvej 100, DK-8200 Aarhus N, Denmark. kristian.groth@ki.audk.
Insights
Severe diarrhea from lymphocytic colitis can lead to dangerous hypokalemia (low potassium), causing cardiac arrest. Prompt electrolyte monitoring is crucial for patients with severe diarrhea to prevent life-threatening events.
Area of Science:
- Internal Medicine
- Cardiology
- Gastroenterology
Background:
- Presents a rare case of cardiac arrest triggered by hypokalemia.
- Hypokalemia was a direct consequence of lymphocytic colitis.
Purpose of the Study:
- To highlight the critical link between severe diarrhea and electrolyte imbalances.
- To emphasize the potential for hypokalemia to cause cardiac arrest.
- To underscore the importance of electrolyte monitoring in patients with severe diarrhea.
Main Methods:
- Case report of a 69-year-old male diagnosed with lymphocytic colitis.
- Detailed description of the patient's cardiac arrest event, resuscitation efforts, and diagnostic findings.
- Analysis of arterial blood gas and electrolyte levels, specifically potassium.
Main Results:
- The patient experienced a witnessed cardiac arrest with recurrent ventricular tachyarrhythmias.
- Arterial blood gas revealed severe hypokalemia (2.0 mmol/L) and acidosis (pH 6.86).
- Correction of potassium levels resolved the ventricular tachyarrhythmias, and the patient recovered without neurological deficit.
Conclusions:
- Severe diarrhea, as seen in lymphocytic colitis, can lead to significant potassium loss.
- Hypokalemia is a potentially fatal complication of severe diarrhea, capable of inducing cardiac arrest.
- Clinicians must consider electrolyte monitoring in patients presenting with severe diarrhea.
Introduction:
We present a case of cardiac arrest due to hypokalemia caused by lymphocytic colitis.
Case Presentation:
A 69-year-old Caucasian man presented four months prior to a cardiac arrest with watery diarrhea and was diagnosed with lymphocytic colitis. Our patient experienced a witnessed cardiac arrest at his general practitioner's surgery. Two physicians and the emergency medical services resuscitated our patient for one hour and four minutes before arriving at our university hospital. Our patient was defibrillated 16 times due to the recurrence of ventricular tachyarrhythmias. An arterial blood sample revealed a potassium level of 2.0 mmol/L (reference range: 3.5 to 4.6 mmol/L) and pH 6.86 (reference range: pH 7.37 to 7.45). As the potassium level was corrected, the propensity for ventricular tachyarrhythmias ceased. Our patient recovered from his cardiac arrest without any neurological deficit. Further tests and examinations revealed no other reason for the cardiac arrest.
Conclusion:
Diarrhea can cause life-threatening situations due to the excretion of potassium, ultimately causing cardiac arrest due to hypokalemia. Physicians treating patients with severe diarrhea should consider monitoring their electrolyte levels.
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