Open AccessA rare case of hypokalemic ventricular tachycardia in a patient with thyrotoxic periodic paralysis
Author(s) -
Bader Abu Ghalyoun,
Ibrahim Khaddash,
Dema Shamoon,
Hamid Shaaban,
Michael Hanna,
Satish Tiyyagura,
Mourad Ismail
Publication year - 2019
Publication title -
international journal of critical illness and injury science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.274
H-Index - 12
eISSN - 2231-5004
pISSN - 2229-5151
DOI - 10.4103/ijciis.ijciis_39_17
Subject(s) - hypokalemia , medicine , thyrotoxic periodic paralysis , amiodarone , paralysis , periodic paralysis , tachycardia , anesthesia , complication , cardiology , electrolyte disorder , muscle weakness , ventricular tachycardia , hyponatremia , surgery , atrial fibrillation
Thyrotoxic periodic paralysis (TPP) is a potentially fatal complication of hyperthyroidism, characterized by recurrent muscle paralysis and hypokalemia. We present a case of a 32-year-old apparently healthy male patient, who presented with acute paraparesis associated with hypokalemia (K: 1.6 mmol/L), complicated by ventricular tachycardia (VT). Advanced cardiac life support was initiated with an amiodarone infusion, and eventually QRS complex narrowed and wide complex tachycardia resolved. Intravenous potassium chloride (KCl) 40 mEq over 2-3 h and oral KCL 40 mEq were administered to treat the electrolyte imbalance. Patient paralysis was quickly reversed; motor function was regained with movement of the lower extremities. This case highlights the importance of early recognition and prompt treatment of TPP as a differential diagnosis for muscle weakness, especially in the setting of severe hypokalemia. It is important to pay attention to the possibility of the development of lethal VT associated with hypokalemia in the setting of hyperthyroidism and thyrotoxic paralysis.