REVERSIBLE MYOCARDIAL DYSFUNCTION IN A PATIENT WITH ALCOHOLIC KETOACIDOSIS - A ROLE FOR HYPOPHOSPHATEMIA

A 39 year old-woman had alcoholic ketoacidosis complicated by reversib le life-threatening myocardial dysfunction, This complication occurred a few hours after correction of acidosis in association with severe h ypophosphatemia. A marked improvement in clinical, echocardiographic, and hemodynamic features was associated with the normalization of the serum phosphorus level. This case illustrates a rare complica tion of hypophosphatemia, emphasizing the need for emergency physicians to con sider this metabolic disorder in the treatment of patients with alcoho lic ketoacidosis, The pathogenesis of hypophosphatemia in alcoholic ke toacidosis, its potential role in myocardial dysfunc tion, and its the rapeutic implications in emergencies are discussed. (Am J Emerg Med 19 98;16:371-373. Copyright (C) 1998 by W.B. Saunders Company).