TY - JOUR
T1 - Torsade de Pointes with severe vitamin D deficiency, an unusual presentation of a common problem
AU - Halawa, Ahmad
AU - Dave, Isha
AU - Gautam, Sandeep
N1 - Publisher Copyright:
© 2019
PY - 2019/10
Y1 - 2019/10
N2 - Torsade de Pointes (TdP) is a rare cardiac arrhythmia that is associated with prolonged QTc interval. Hypocalcemia is a common cause of prolonged QTc. Although vitamin D deficiency (VDD) is a common disorder in elderly patients with an incidence rate of >40% and can cause hypocalcemia, it has never been linked to TdP. We report a patient with severe VDD that resulted in TdP and cardiac arrest. Post-resuscitation work up illustrated prolonged QTc interval of 620 ms, significant hypocalcemia, and severe VDD of 4 (normal 30–80) ng/mL. After high dose vitamin D/calcium supplements, repeat electrocardiogram revealed normal QTc interval of 423 ms. During hospitalization, the patient suffered no additional arrhythmias and QTc continued to be normal. <Learning objective: Severe vitamin D deficiency is common especially in elderly patients. The diagnosis and treatment of this disorder are simple, but the consequences of severe depletion of vitamin D storage can lead to deep electrolyte abnormalities and life-threatening arrhythmia such as Torsade de Pointes. A simple screening test is effective in preventing a dreadful outcome.>
AB - Torsade de Pointes (TdP) is a rare cardiac arrhythmia that is associated with prolonged QTc interval. Hypocalcemia is a common cause of prolonged QTc. Although vitamin D deficiency (VDD) is a common disorder in elderly patients with an incidence rate of >40% and can cause hypocalcemia, it has never been linked to TdP. We report a patient with severe VDD that resulted in TdP and cardiac arrest. Post-resuscitation work up illustrated prolonged QTc interval of 620 ms, significant hypocalcemia, and severe VDD of 4 (normal 30–80) ng/mL. After high dose vitamin D/calcium supplements, repeat electrocardiogram revealed normal QTc interval of 423 ms. During hospitalization, the patient suffered no additional arrhythmias and QTc continued to be normal. <Learning objective: Severe vitamin D deficiency is common especially in elderly patients. The diagnosis and treatment of this disorder are simple, but the consequences of severe depletion of vitamin D storage can lead to deep electrolyte abnormalities and life-threatening arrhythmia such as Torsade de Pointes. A simple screening test is effective in preventing a dreadful outcome.>
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U2 - 10.1016/j.jccase.2019.07.003
DO - 10.1016/j.jccase.2019.07.003
M3 - Article
AN - SCOPUS:85070531311
VL - 20
SP - 132
EP - 134
JO - Journal of Cardiology Cases
JF - Journal of Cardiology Cases
SN - 1878-5409
IS - 4
ER -