scholarly journals New-Onset Complete Heart Block Later Complicated by Decompensated Heart Failure Following COVID-19 Infection

2021 ◽  
pp. 47-49
Author(s):  
Katrina Ngo ◽  
Sheldon Myers ◽  
Ramanna Merla ◽  
Ronald Chang
Keyword(s):  
Heart Block ◽  
Complete Heart Block ◽  
Chronic Kidney Disease Stage ◽  
Respiratory Illness ◽  
Decompensated Heart Failure ◽  
Disease Stage ◽  
Main Concern ◽  
Diabetes Mellitus Type Ii ◽  
Organ Systems ◽  
Diagnosed Diabetes

Coronavirus disease 2019 (COVID-19) is caused by a strain of coronavirus known as severe acute respiratory syndrome coronavirus 2. Although respiratory illness remains the main concern regarding COVID-19 infection, multiple other organ systems have been reported to have also been affected, more prominently, the cardiovascular system.3 We present a 54-year-old male with a history of newly diagnosed diabetes mellitus type II and chronic kidney disease stage II who presented to the emergency department with progressive dyspnea, myalgias, fever, and malaise and was subsequently found to have complete heart block.

scholarly journals Thyroid Storm and Complete Heart Block after Treatment with Radioactive Iodine

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Kaitlyn Vennard ◽  
Matthew P. Gilbert
Keyword(s):  
Heart Block ◽  
Radioactive Iodine ◽  
Radioiodine Therapy ◽  
Complete Heart Block ◽  
Multiple Organ ◽  
Thyroid Storm ◽  
Metabolic Abnormalities ◽  
Organ Systems ◽  
Life Threatening ◽  
Life Threatening Complication

Thyroid storm is a rare endocrine emergency characterized by dysfunction of multiple organ systems. Thyroid storm is more common in Graves’ disease and can be precipitated by surgery, trauma, infection, metabolic abnormalities, iodine load, and parturition. We present a diagnostically challenging case of thyroid storm precipitated by radioiodine therapy and accompanied by bradycardia, a rare but life-threatening complication related to treatment for hyperthyroidism.

scholarly journals SAT-LB110 Sulfonylurea-Induced Hypoglycemia: To Use Octreotide or Not

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jose Romeu ◽  
Hannah Dodge ◽  
Chad Mears ◽  
Erin Kozlow ◽  
Ravi Patel ◽  
...  
Keyword(s):  
Glucose Level ◽  
Normal Saline ◽  
Chronic Kidney Disease Stage ◽  
Kidney Injury ◽  
Central Line ◽  
Saline Infusion ◽  
Disease Stage ◽  
Diabetes Mellitus Type Ii ◽  
Glucose Levels ◽  
Intravenous Dextrose

Abstract Background: Sulfonylurea poisoning can cause sustained hypoglycemia refractory to intravenous dextrose. Traditional treatment for sulfonylurea induced hypoglycemia includes intravenous dextrose and glucagon as well as diazoxide in refractory cases. Octreotide is recommended for sulfonylurea poisoning in adult and pediatric patients with laboratory evidence of hypoglycemia. Clinical Case: An 89 year-old female with chronic kidney disease stage III, hypothyroidism, and diabetes mellitus type II, hypertension who presented with intractable nausea and diarrhea. Patient had been taking cefdinir for an UTI the prior week. On CT scan of the abdomen, colitis was demonstrated. Clostridium Difficile Assay was positive. She was incidentally found to have profound hypoglycemia with a blood glucose level of 30 mg/dL. Patient had hypoglycemia unawareness. Despite receiving 4 ampules of dextrose 50%, glucose level did not significantly improve. In the ED, patient was afebrile and hemodynamically stable. Her labs were significant for a hyponatremia of 125 mmol/L with an acute kidney injury [AKI] (Cr 1.94 mg/dL from 1.5 mg/dL). Patient was placed initially on a dextrose 5% normal saline infusion, but glucose levels continued to decline after brief response. Due to poor IV access, internal jugular central line was placed and patient was placed on D10NS infusion with good glycemic response. Patient had taken sulfonylurea despite not eating appropriately for 2 days. After 24 hours on D10 normal saline infusion, patient was able to maintain normal to slightly hyperglycemic levels with consistent carbohydrate diet. Her nausea and diarrhea had considerably improved after starting vancomycin 125 mg every 6 hours. Sulfonyurea was indefinitely discontinued. Conclusion: Patients presenting with sulfonylurea induced hypoglycemia complicated by poor PO intake, AKI, and infection can be safely treated with supportive measures like proper hydration, and dextrose infusion medication is appropriately metabolized by body without the need for octreotide infusion. References:Glatstein M, Scolnik D, Bentur Y. Octreotide forthe treatment of sulfonylurea poisoning.Clin Toxicol (Phila). 2012 Nov;50(9):795-804. doi:10.3109/15563650.2012.734626. Epub 2012 Oct 10.

Lyme Carditis With Complete Heart Block Successfully Treated With Oral Doxycycline

2021 ◽  
Author(s):  
Michael Burns ◽  
Paul Robben ◽  
Ramesh Venkataraman
Keyword(s):  
Lyme Disease ◽  
Heart Block ◽  
Complete Heart Block ◽  
Subsequent Development ◽  
Exercise Stress ◽  
Exercise Intolerance ◽  
Cardiac Monitoring ◽  
Oral Doxycycline ◽  
Lyme Carditis ◽  
Organ Systems

ABSTRACT Lyme disease is a vector-borne infection that can affect multiple different organ systems. Lyme carditis represents one of these sequelae and is defined by acute onset of high-grade atrioventricular block in the presence of laboratory-confirmed infection. Current guidelines recommend patients with Lyme carditis be admitted for close cardiac monitoring and intravenous antibiotics therapy. Our case illustrates an active duty male who was initially diagnosed with Lyme disease after initially reporting symptoms including headache, fever, eye pain, and rash, with subsequent development of exercise intolerance 6 weeks later. An electrocardiogram (ECG) obtained at that time was misinterpreted as first-degree heart block, and he was initiated on oral doxycycline therapy and referred to cardiology. On follow-up to cardiology clinic, the prior ECG was reviewed and interpreted as complete heart block. A repeat ECG showed resolution of the heart block, and exercise stress testing showed chronotropic competence. This case illustrates the resolution of complete heart block in Lyme carditis with oral doxycycline, suggesting this antibiotic as a possible alternative treatment agent.

Phosphate binders in patients with chronic kidney disease: Between the new and the old.

2019 ◽  
pp. 2-3
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Estimated Glomerular Filtration Rate ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Phosphate Binders ◽  
Advanced Chronic Kidney Disease ◽  
Phosphate Retention ◽  
Stage 4 ◽  
Dietary Phosphate

Impaired phosphate excretion by the kidney leads to Hyperphosphatemia. It is an independent predictor of cardiovascular disease and mortality in patients with advanced chronic kidney disease (stage 4 and 5) particularly in case of dialysis. Phosphate retention develops early in chronic kidney disease (CKD) due to the reduction in the filtered phosphate load. Overt hyperphosphatemia develops when the estimated glomerular filtration rate (eGFR) falls below 25 to 40 mL/min/1.73 m2. Hyperphosphatemia is typically managed with oral phosphate binders in conjunction with dietary phosphate restriction. These drugs aim to decrease serum phosphate by binding ingested phosphorus in the gastrointestinal tract and its transformation to non-absorbable complexes [1].

Congenital Complete Heart Block

2007 ◽  
Vol 3 (2) ◽  
pp. 111
Author(s):  
Robert Campbell ◽  
Peter Fischbach ◽  
Patricio Frias ◽  
Margaret Strieper ◽  
◽  
...  
Keyword(s):  
Heart Block ◽  
Complete Heart Block ◽  
Congenital Complete Heart Block

1049-P: Preexisting Chronic Kidney Disease Stage 3 Does Not Reduce Glycemic Efficacy of Metformin in U.S. Veterans with Type 2 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1049-P
Author(s):  
ELVIRA GOSMANOVA ◽  
DARREN E. GEMOETS ◽  
LAURENCE S. KAMINSKY ◽  
CSABA P. KOVESDY ◽  
AIDAR R. GOSMANOV
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage
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