Cardiac complications in pediatric patients on the ketogenic diet

Cardiac complications of the ketogenic diet, in the absence of selenium def iciency, have not been reported. Twenty patients on the ketogenic diet at o ne institution were investigated. Prolonged QT interval (QTc) was found in 3 patients (15%). There was a significant correlation between prolonged QTc and both low serum bicarbonate and high beta-hydroxybutyrate. In addition, three patients had evidence of cardiac chamber enlargement. One patient wi th severe dilated cardiomyopathy and prolonged QTc normalized when the diet was discontinued.