Key result
Respiratory alkalosis in a mechanically ventilated patient with acute ischemic heart failure caused refractory hypokalemia, leading to bidirectional ventricular tachycardia and electrical storm.
Case Report (n=1)
Highlights that respiratory alkalosis can cause refractory hypokalemia leading to bidirectional ventricular tachycardia and electrical storm in acute ischemic heart failure.
Alerts clinicians to consider respiratory alkalosis in refractory hypokalemia with electrical storm; hypothesis-generating case leaves broader applicability open.
Bidirectional ventricular tachycardia (BVT) is a rare arrhythmia that is generally observed in patients with catecholaminergic ventricular tachycardia or digoxin overdose. Herein, we present a case of BVT and electrical storm (ES) in an acute ischemic heart failure patient that is typically induced by hypokalemia. The patient was in invasive mechanical ventilator (MV) support and hypokalemia was related to acute respiratory alkalosis and that caused refractory hypokalemia despite intravenous (IV) potassium replacement. We also discuss our approach to solve refractory hypokalemia caused by respiratory alkalosis.
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Külahçıoğlu et al. (2021) conducted a case report in Acute ischemic heart failure (n=1). Management of respiratory alkalosis and intravenous potassium replacement was evaluated. Respiratory alkalosis in a mechanically ventilated patient with acute ischemic heart failure caused refractory hypokalemia, leading to bidirectional ventricular tachycardia and electrical storm.
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