title: Marked sinus bradycardia and QT prolongation in a diabetic patient with severe hypoglycemia.
abstract: We report an uncommon case of an insulin-treated diabetic patient, presenting severe hypoglycemia, coma, marked sinus bradycardia and QT prolongation. Intravenous administration of glucose and atropine awaked the patient and increased heart rate but did not affect QT prolongation. Basal and exercise electrocardiogram excluded primary diseases associated with QT prolongation. Pathophysiologic aspects of electrocardiographic and clinical findings occurring in the hypoglycemic patients are briefly discussed.
authors.affiliation: Chair of Cardiology, Dipartment of Internal Medicine and Biomedical Sciences, University of Parma, Parma, Italy. roberto.bolognesi@unipr.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Bolognesi
authors.forename: Dimitri
authors.initials: D
authors.lastname: Tsialtas
authors.forename: Maria Giulia
authors.initials: MG
authors.lastname: Bolognesi
authors.forename: Claudio
authors.initials: C
authors.lastname: Giumelli
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001285:Atropine / Q000627:therapeutic use; D061265:Biphasic Insulins / Q000009:adverse effects / Q000627:therapeutic use; D001919:Bradycardia / Q000150:complications / Q000188:drug therapy / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D003926:Diabetic Coma / Q000209:etiology; D005260:Female; D005947:Glucose / Q000627:therapeutic use; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology / Q000503:physiopathology*; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D008133:Long QT Syndrome / Q000150:complications / Q000209:etiology*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D061265:Biphasic Insulins; D007004:Hypoglycemic Agents; D001285:Atropine; D005947:Glucose