HYPOGLYCEMIA MANIFESTED BY SINUS BRADYCARDIA - A REPORT OF 3 CASES

Three cases are reported of hypoglycemia manifested by profound sinus bradycardia and fatigue, which responded to IV dextrose with prompt no rmalization of the cardiac rhythm. The cases involved 3 different pati ents and disease processes: a young female who had anorexia nervosa an d profound malnutrition; an elderly, nondiabetic male who subsequently experienced a transient ischemic attack; and a patient who had diabet es mellitus managed with chronic, subcutaneous insulin administration. It is vitally important that the emergency physician recognize unusua l clinical manifestations-of hypoglycemia and fully evaluate such scen arios when hypoglycemia may occur. Untreated, hypoglycemia may result in significant chronic morbidity, and rarely, in death, Bradyarrhythmi as-particularly sinus bradycardia-should be added to the list of poten tial clinical manifestations of hypoglycemia.