Sinus arrest associated with diabetic ketoacidosis regressing to sinus rhythm after compensation of diabetic process: a case report and review of literature

Abstract Background Diabetic ketoacidosis (DKA) is a serious, life-threatening condition known for its profound hydro electrolytic disturbances and multiple complications, including cerebral edema and circulatory collapse. While this complication is traditionally associated with patients suffering f...

Full description

Bibliographic Details
Main Authors: Abderrahmane Bouchaala, Jaouad Nguadi, Najat Mouine, Hicham Bouzelmat, Aatif Benyass
Format: Article
Language:English
Published: SpringerOpen 2024-01-01
Series:The Egyptian Journal of Internal Medicine
Subjects:
Online Access:https://doi.org/10.1186/s43162-023-00272-7
_version_ 1797362877813751808
author Abderrahmane Bouchaala
Jaouad Nguadi
Najat Mouine
Hicham Bouzelmat
Aatif Benyass
author_facet Abderrahmane Bouchaala
Jaouad Nguadi
Najat Mouine
Hicham Bouzelmat
Aatif Benyass
author_sort Abderrahmane Bouchaala
collection DOAJ
description Abstract Background Diabetic ketoacidosis (DKA) is a serious, life-threatening condition known for its profound hydro electrolytic disturbances and multiple complications, including cerebral edema and circulatory collapse. While this complication is traditionally associated with patients suffering from type 1 diabetes, numerous studies have documented its non-negligible incidence in type 2 diabetics. However, conductive disorders that manifest during its course, such as sinus arrest, are poorly reported and can be life-threatening on their own when not promptly recognized and treated. The primary objective of this report is to increase awareness regarding the uncommon conduction complications associated with diabetic ketoacidosis, even in the absence of overt hyperkalemia, and to underscore the critical significance of early diagnosis and prompt intervention in managing these complications. Case presentation We present the case of a middle-aged man with past history of type 2 diabetes whose symptoms included asthenia and consciousness disorder concomitant with ketoacidosis decompensation. Electrocardiogram (ECG) revealed the presence of sinus arrest with ventricular escaping rhythm. Rapid management of the diabetic decompensation led to spontaneous restoration of normal sinus rhythm, thus obviating the necessity for permanent pacing in the patient. Conclusions Atypical complications arising during ketoacidosis decompensation, including conditions like sinus arrest, are frequently overlooked and tend to carry a guarded prognosis. Proper recognition and prompt treatment are imperative to achieve the optimal clinical outcome.
first_indexed 2024-03-08T16:13:44Z
format Article
id doaj.art-d08e067ec771478bbecdc534408ae021
institution Directory Open Access Journal
issn 2090-9098
language English
last_indexed 2024-03-08T16:13:44Z
publishDate 2024-01-01
publisher SpringerOpen
record_format Article
series The Egyptian Journal of Internal Medicine
spelling doaj.art-d08e067ec771478bbecdc534408ae0212024-01-07T12:47:55ZengSpringerOpenThe Egyptian Journal of Internal Medicine2090-90982024-01-013611610.1186/s43162-023-00272-7Sinus arrest associated with diabetic ketoacidosis regressing to sinus rhythm after compensation of diabetic process: a case report and review of literatureAbderrahmane Bouchaala0Jaouad Nguadi1Najat Mouine2Hicham Bouzelmat3Aatif Benyass4Clinical Cardiology Department, Cardiology Center, Mohammed V Military Instruction Hospital of RabatRhythmology Department, Cardiology Center, Mohammed V Military Instruction Hospital of Rabat, Mohammed V UniversityClinical Cardiology Department, Cardiology Center, Mohammed V Military Instruction Hospital of RabatRhythmology Department, Cardiology Center, Mohammed V Military Instruction Hospital of Rabat, Mohammed V UniversityClinical Cardiology Department, Cardiology Center, Mohammed V Military Instruction Hospital of RabatAbstract Background Diabetic ketoacidosis (DKA) is a serious, life-threatening condition known for its profound hydro electrolytic disturbances and multiple complications, including cerebral edema and circulatory collapse. While this complication is traditionally associated with patients suffering from type 1 diabetes, numerous studies have documented its non-negligible incidence in type 2 diabetics. However, conductive disorders that manifest during its course, such as sinus arrest, are poorly reported and can be life-threatening on their own when not promptly recognized and treated. The primary objective of this report is to increase awareness regarding the uncommon conduction complications associated with diabetic ketoacidosis, even in the absence of overt hyperkalemia, and to underscore the critical significance of early diagnosis and prompt intervention in managing these complications. Case presentation We present the case of a middle-aged man with past history of type 2 diabetes whose symptoms included asthenia and consciousness disorder concomitant with ketoacidosis decompensation. Electrocardiogram (ECG) revealed the presence of sinus arrest with ventricular escaping rhythm. Rapid management of the diabetic decompensation led to spontaneous restoration of normal sinus rhythm, thus obviating the necessity for permanent pacing in the patient. Conclusions Atypical complications arising during ketoacidosis decompensation, including conditions like sinus arrest, are frequently overlooked and tend to carry a guarded prognosis. Proper recognition and prompt treatment are imperative to achieve the optimal clinical outcome.https://doi.org/10.1186/s43162-023-00272-7Diabetic ketoacidosisComplicationSinus arrestDiabetes mellitus
spellingShingle Abderrahmane Bouchaala
Jaouad Nguadi
Najat Mouine
Hicham Bouzelmat
Aatif Benyass
Sinus arrest associated with diabetic ketoacidosis regressing to sinus rhythm after compensation of diabetic process: a case report and review of literature
The Egyptian Journal of Internal Medicine
Diabetic ketoacidosis
Complication
Sinus arrest
Diabetes mellitus
title Sinus arrest associated with diabetic ketoacidosis regressing to sinus rhythm after compensation of diabetic process: a case report and review of literature
title_full Sinus arrest associated with diabetic ketoacidosis regressing to sinus rhythm after compensation of diabetic process: a case report and review of literature
title_fullStr Sinus arrest associated with diabetic ketoacidosis regressing to sinus rhythm after compensation of diabetic process: a case report and review of literature
title_full_unstemmed Sinus arrest associated with diabetic ketoacidosis regressing to sinus rhythm after compensation of diabetic process: a case report and review of literature
title_short Sinus arrest associated with diabetic ketoacidosis regressing to sinus rhythm after compensation of diabetic process: a case report and review of literature
title_sort sinus arrest associated with diabetic ketoacidosis regressing to sinus rhythm after compensation of diabetic process a case report and review of literature
topic Diabetic ketoacidosis
Complication
Sinus arrest
Diabetes mellitus
url https://doi.org/10.1186/s43162-023-00272-7
work_keys_str_mv AT abderrahmanebouchaala sinusarrestassociatedwithdiabeticketoacidosisregressingtosinusrhythmaftercompensationofdiabeticprocessacasereportandreviewofliterature
AT jaouadnguadi sinusarrestassociatedwithdiabeticketoacidosisregressingtosinusrhythmaftercompensationofdiabeticprocessacasereportandreviewofliterature
AT najatmouine sinusarrestassociatedwithdiabeticketoacidosisregressingtosinusrhythmaftercompensationofdiabeticprocessacasereportandreviewofliterature
AT hichambouzelmat sinusarrestassociatedwithdiabeticketoacidosisregressingtosinusrhythmaftercompensationofdiabeticprocessacasereportandreviewofliterature
AT aatifbenyass sinusarrestassociatedwithdiabeticketoacidosisregressingtosinusrhythmaftercompensationofdiabeticprocessacasereportandreviewofliterature