A rare case of hypokalemic ventricular tachycardia in a patient with thyrotoxic periodic paralysis

Abstract

Thyrotoxic periodic paralysis (TPP) is a potentially fatal complication of hyperthyroidism, characterized by recurrent muscle paralysis and hypokalemia. We present a case of a 32-year-old apparently healthy male patient, who presented with acute paraparesis associated with hypokalemia (K: 1.6 mmol/L), complicated by ventricular tachycardia (VT). Advanced cardiac life support was initiated with an amiodarone infusion, and eventually QRS complex narrowed and wide complex tachycardia resolved. Intravenous potassium chloride (KCl) 40 mEq over 2–3 h and oral KCL 40 mEq were administered to treat the electrolyte imbalance. Patient paralysis was quickly reversed; motor function was regained with movement of the lower extremities. This case highlights the importance of early recognition and prompt treatment of TPP as a differential diagnosis for muscle weakness, especially in the setting of severe hypokalemia. It is important to pay attention to the possibility of the development of lethal VT associated with hypokalemia in the setting of hyperthyroidism and thyrotoxic paralysis.

Paralisia Periódica Hipocalêmica Tireotóxica: Relato De Caso

“…A causa da formação do Torsades de Pointes ou da TV pode ser a hipocalemia, que leva a brilação e morte se não houver tratamento imediato. Nessa situação, ocorre aumento do potencial de membrana em repouso, duração do potencial de ação e do período refratário, elevando o risco de arritmias cardíacas (GHALYOUN et al, 2019). As alterações eletrocardiográ cas ocorrem pelo distúrbio no equilíbrio iônico na PPHT em consequência do aumento, incompatível, da excitabilidade dos cardiomiócitos por meio da hiperpolarização do potencial da membrana em repouso (VALADÃO et al, 2021).…”

Thyrotoxic periodic paralysis after urethral dilatation

“…It rarely affects ocular, bulbar, or respiratory muscles, but there have been reports of ventilatory impairment. [ 1 4 ]…”