A Case of Hemodynamically Unstable Sick Sinus Syndrome Secondary to Refeeding Syndrome
HCA Houston Healthcare West
refeeding syndrome, sick sinus syndrome, cardiogenic shock, cardiac arrhythmia, tachy-brady syndrome
Cardiology | Cardiovascular Diseases | Critical Care | Family Medicine | Internal Medicine | Nutritional and Metabolic Diseases
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
Mgerian M, Havican S, Wolf F, Karim N. A Case of Hemodynamically Unstable Sick Sinus Syndrome Secondary to Refeeding Syndrome. Cureus. 2021;13(4):e14625. doi:10.7759/cureus.14625