Life-Threatening Ventricular Tachyarrhythmias in Delirium Tremens

Fisher, John F.; Abrams, Jonathan

doi:10.1001/archinte.1977.03630210104030

Cited by 22 publications

(4 citation statements)

References 27 publications

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“…Although infrequently seen, athetoid and choreoiform movements are manifestations of magnesium defi ciency (24,25,27,71). Central nervous system symptoms such as nystagmus, ataxia, and vertigo as well as psychiatric abnormalities have been reported (24,26,27,71) CARDIOVASCULAR An important and serious clinical manifestation of magnesium deficiency is cardiac arrhythmia (72)(73)(74)(75)(76). Chronic magnesium deficiency results in changes in the electrocardiogram such as pro longed P-R and Q-T intervals and fiat, broad T waves (74,77).…”

Section: Manifestationsmentioning

confidence: 99%

“…These changes are similar to those seen in hypokalemia, and lead one to speculate that these changes are secondary to the effect of magnesium depletion on potassium metabolism (76, 78) as discussed above. Arrhythmias such as premature ventricular beats, ventricular tachycardia, and ventricular fibril lation have been reported (72)(73)(74)(75)(76). The potential role of magnesium defi ciency in triggering such arrhythmias must be kept in mind since standard antiarrhythmic drug therapy may be ineffective in controlling ventricular arrhythmias associated with magnesium deficiency (72,73,76).…”

Section: Manifestationsmentioning

confidence: 99%

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Magnesium Deficiency and Excess

Rude¹,

Singer²

1981

Annu. Rev. Med.

192

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Section: Manifestationsmentioning

confidence: 99%

Section: Manifestationsmentioning

confidence: 99%

Magnesium Deficiency and Excess

Rude¹,

Singer²

1981

Annu. Rev. Med.

192

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“…The pathogenesis of hypokalaemia in chronic alcoholism is poorly understood, and may result from decreased intake and absorption, increased renal or intestinal losses, and potassium shift from extracellular into intracellular compartments when glucose infusion is given. Findings of the present study suggest that alcoholics with impaired niacin status are also prone to hypokalaemia, possibly secondary to diarrhoea, which can predispose these patients to QTc prolongation, and increased risk of ventricular irritability, and sudden death (Fisher & Abrams, 1977).…”

Section: Discussionmentioning

confidence: 69%

Serum electrolytes in hospitalized pellagra alcoholics

et al. 2000

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Background: Owing to high diarrhoea and protein malnutrition frequencies in pellagra, we hypothesised that pellagra patients would have higher electrolyte disturbances than non-pellagra alcoholics. Objective: To compare serum electrolytes of hospitalised alcoholics with or without pellagra. Design: Retrospective and descriptive case-control study. Setting: Internal Medicine wards at a University Hospital, Medical School of Uberaba, Brazil. Subjects: Medical records were reviewed to obtain relevant clinical details, main diagnosis and laboratory data, including serum electrolytes on hospital admission of pellagra patients (n 33) and a randomly chosen control group of alcoholics (n 37), matched in age, gender and socio-economic status. Anaemia was ascertained by haemoglobin`12.5 gadl (men) and 1.5 gadl (women), and hypoalbuminemia by serum albumin`3.3 gadl. Results: Pellagra and controls showed similar age (39.4 AE 13.1 vs 45.0 AE 11.4 years) and a male predominance of gender (69.7 vs 78.4%), and similar associated diagnoses, including high blood pressure (21.2 vs 16.2%), peripheral neuropathy (12.1 vs 13.5%), and pneumonia (9.1 vs 13.5%). Despite displaying similar serum sodium (136.6 AE 6.1 vs 137.8 AE 5.7 mEqaI), magnesium (1.72 AE 0.74 vs 1.62 AE 0.34 mgadl), phosphorus (3.79 AE 0.87 vs 3.87 AE 0.78 mEqa1) than controls,in addition to higher hypoalbuminemia (76.2 vs 33%) and anaemia (60.6 vs 35.1%) frequencies. Conclusions: Higher anaemia and hypoalbuminemia frequencies associated with lower serum potassium levels suggest increased protein malnutrition prevalence among pellagrins.

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“…Infectious diseases, especially pneumonia, hyperthermia and cardiac arrhythmias are the most common complications in the course of delirium tremens (DT). 1…”

Section: Introductionmentioning

confidence: 99%

Severe electrolyte abnormalities and paralytic ileus complicating delirium tremens.

et al. 1989

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Pneumonia and cardiac arrhythmias represent the most common life-threatening complications during delirium tremens. Electrolyte abnormalities are common underlying conditions in chronic alcoholics and they may further com plicate the management of patients with alcohol-withdrawal syndrome or with delirium tremens. The authors present two cases in which the clinical picture of severe paralytic ileus complicating delirium tremens was closely associated with electrolyte status and postulate that the two were cause-effect related. A careful electrolyte supplement therapy guided by a strict monitoring of electrolyte balance and renal function proved to be particularly useful in successful manage ment.

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Life-Threatening Ventricular Tachyarrhythmias in Delirium Tremens

Cited by 22 publications

References 27 publications

Magnesium Deficiency and Excess

Magnesium Deficiency and Excess

Serum electrolytes in hospitalized pellagra alcoholics

Severe electrolyte abnormalities and paralytic ileus complicating delirium tremens.

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