Reversible myocardial dysfunction in a patient with alcoholic ketoacidosis: a role for hypophosphatemia.
A 39-year-old woman had alcoholic ketoacidosis complicated by reversible life-threatening myocardial dysfunction. This complication occurred a few hours after correction of acidosis in association with severe hypophosphatemia. A marked improvement in clinical, echocardiographic, and hemodynamic features was associated with the normalization of the serum phosphorus level. This case illustrates a rare complication of hypophosphatemia, emphasizing the need for emergency physicians to consider this metabolic disorder in the treatment of patients with alcoholic ketoacidosis. The pathogenesis of hypophosphatemia in alcoholic ketoacidosis, its potential role in myocardial dysfunction, and its therapeutic implications in emergencies are discussed.
Machiels
J P
JP
Department of Intensive Care Medicine, Mont-Godinne University Hospital, Louvain School of Medicine, Yvoir, Belgium.
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Donckier
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D000328:Adult; D000437:Alcoholism / Q000150:complications*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D017674:Hypophosphatemia / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D007662:Ketosis / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D010710:Phosphates / Q000627:therapeutic use; D017680:Potassium Compounds / Q000627:therapeutic use; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology
D010710:Phosphates; D017680:Potassium Compounds; C013216:potassium phosphate