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Supraventricular tachycardia associated with severe diabetic ketoacidosis in a child with new-onset type 1 diabetes mellitus

Part of: Echocardiography

Published online by Cambridge University Press:  31 January 2022

Ayed A. Shati Open the ORCID record for Ayed A. Shati [Opens in a new window] ,
Own J. Al-Asmari ,
Abdullah A. Alhayani ,
Youssef A. Alqahtani ,
Salem A. Alshehri  and
Ibrahim A. Alhelali
Ayed A. Shati*
Affiliation:
Department of Child Health, College of Medicine, King Khalid University, Abha, Saudi Arabia
Own J. Al-Asmari
Affiliation:
Department of Pediatrics, Abha Maternity and Children Hospital, Abha, Saudi Arabia
Abdullah A. Alhayani
Affiliation:
Department of Pediatrics, Abha Maternity and Children Hospital, Abha, Saudi Arabia
Youssef A. Alqahtani
Affiliation:
Department of Child Health, College of Medicine, King Khalid University, Abha, Saudi Arabia
Salem A. Alshehri
Affiliation:
Department of Pediatrics, Abha Maternity and Children Hospital, Abha, Saudi Arabia
Ibrahim A. Alhelali
Affiliation:
Pediatric Critical Care Unit, Abha Maternity and Children Hospital, Abha, Saudi Arabia
*
Author for correspondence: Ayed. A. Shati, Department of Child Health, College of Medicine, King Khalid University, P.O. Box 641, Abha, Saudi Arabia. Tel: 00966-555752063. Email: [email protected]
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Abstract

Diabetic ketoacidosis is one of the most serious and common complications of diabetes, with between 15 and 70% of new-onset type 1 diabetes mellitus worldwide presented with diabetic ketoacidosis. Supraventricular tachycardia, however, is an infrequent complication of diabetic ketoacidosis. We present the case of a child with a new-onset type 1 diabetes mellitus with supraventricular tachycardia as a complication of paediatric diabetic ketoacidosis. The patient received intravenous fluid resuscitation, insulin, and potassium supplementation and subsequently developed stable supraventricular tachycardia initially, confirmed on a 12-lead electrocardiogram despite a structurally normal heart and normal electrolytes. Vagal manoeuvers failed to achieve sinus rhythm. The patient went into respiratory distress and was intubated, for mechanical ventilation. She received one dose of adenosine with successful conversion to sinus rhythm and a heart rate decreased from 200 to 140 beats per minutes. We conclude that supraventricular tachycardia can occur as a complication of diabetic ketoacidosis, including in new-onset type 1 diabetes mellitus. Furthermore, a combination of acidosis, potassium derangement, falling magnesium, and phosphate levels may have precipitated the event. Here, we report a case of supraventricular tachycardia as a complication of paediatric diabetic ketoacidosis.

Keywords

Supraventricular tachycardiachildDKAtype 1 DM
Type
Brief Report
Information
Cardiology in the Young , Volume 32 , Issue 10 , October 2022 , pp. 1677 - 1680
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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