An unusual cause of ventricular fibrillation.

摘要

In January, 2007, a 44-year-old previously healthy woman was admitted to the emergency department following resuscitation from ventricular fibrillation. Electrocardiogram showed ST depression, but coronary angiography showed no noteworthy stenosis. Transthoracic echocardio-graphy showed severe concentric left ventricular hypertrophy. Repeat electrocardiogram showed no ST depression, but heart-rate-corrected QT interval was prolonged at 579 ms (normal <430 ms). Serum potassium was low at 2-0 mmol/L (3-8-5-0); sodium and magnesium were normal. After 100 mEq of sodium bicarbonate infusion during resuscitation, bicarbonate was 22-7 mmol/L (20-26) and lactate was 11-4 mmol/L (0-2-2), with an arterial pH of 7-43 (7-37-7-45). Potassium chloride was given. Within hours she developed metabolic alkalosis (pH 7-46 and bicarbonate 28 . 1 mmol/L) and hypertension with blood pressure measurements up to 180/105 mm Hg; intravenous antihypertensive therapy was given.