Abstract
IntroductionWe present a case of cardiac arrest due to hypokalemia caused by lymphocytic colitis.Case presentationA 69-year-old Caucasian man presented four months prior to a cardiac arrest with watery diarrhea and was diagnosed with lymphocytic colitis. Our patient experienced a witnessed cardiac arrest at his general practitioner's surgery. Two physicians and the emergency medical services resuscitated our patient for one hour and four minutes before arriving at our university hospital. Our patient was defibrillated 16 times due to the recurrence of ventricular tachyarrhythmias. An arterial blood sample revealed a potassium level of 2.0 mmol/L (reference range: 3.5 to 4.6 mmol/L) and pH 6.86 (reference range: pH 7.37 to 7.45). As the potassium level was corrected, the propensity for ventricular tachyarrhythmias ceased. Our patient recovered from his cardiac arrest without any neurological deficit. Further tests and examinations revealed no other reason for the cardiac arrest.ConclusionDiarrhea can cause life-threatening situations due to the excretion of potassium, ultimately causing cardiac arrest due to hypokalemia. Physicians treating patients with severe diarrhea should consider monitoring their electrolyte levels.
Highlights
We present a case of cardiac arrest due to hypokalemia caused by lymphocytic colitis.Case presentation: A 69-year-old Caucasian man presented four months prior to a cardiac arrest with watery diarrhea and was diagnosed with lymphocytic colitis
Potassium is secreted in the colon and is eliminated in diarrhea; profuse diarrhea can result in hypokalemia
Our patient was admitted to our intensive care unit (ICU) and was defibrillated a further four times due to the recurrence of ventricular tachyarrhythmias
Summary
Untreated inflammatory colitis normally presents with chronic watery diarrhea. Potassium is secreted in the colon and is eliminated in diarrhea; profuse diarrhea can result in hypokalemia. Our patient was admitted to our intensive care unit (ICU) and was defibrillated a further four times due to the recurrence of ventricular tachyarrhythmias As his serum potassium level was corrected, the propensity for ventricular tachyarrhythmias ceased. Four months prior to the cardiac arrest (Figure 1), our patient had presented with chronic watery diarrhea. He initially reported continuous diarrhea with four stools per day without warning symptoms. The glucocorticoid was discontinued and our patient was recommended psyllium seed treatment, from which he had previously experienced some relief His potassium level was found to be normal three times during his first two and a half months with diarrhea, but was not monitored during the last one and a half months prior to the cardiac arrest
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