A Case of Hemodynamically Unstable Sick Sinus Syndrome Secondary to Refeeding Syndrome

Division

Gulf Coast

Hospital

HCA Houston Healthcare West

Document Type

Case Report

Publication Date

4-22-2021

Keywords

refeeding syndrome, sick sinus syndrome, cardiogenic shock, cardiac arrhythmia, tachy-brady syndrome

Disciplines

Cardiology | Cardiovascular Diseases | Critical Care | Family Medicine | Internal Medicine | Nutritional and Metabolic Diseases

Abstract

Prolonged malnourished states can predispose patients to refeeding syndrome with the uncommon complication of cardiogenic shock if not corrected initially. While refeeding syndrome is well studied its complications may not be easily identified in the setting of rapid deterioration. This case report reviews the events of a 57-year-old male who was brought in by law enforcement, for altered mental status and agitation, after being found wandering in the woods. The patient was initially hemodynamically stable but developed cardiogenic shock from sick sinus syndrome. The patient's shock was non-responsive to IV fluid resuscitation and required ICU admission. Congestive heart failure, ischemic cardiomyopathy, substance abuse, myocarditis, and endocarditis were considered but ruled out. Patient's symptoms improved after electrolyte repletion following brief ICU admission with dopamine drip.

Publisher or Conference

Cureus

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