Methamphetamine-Induced Tachydysrhythmia in an Adolescent in Diabetic Ketoacidosis

J Emerg Med. 2019 Jun;56(6):e111-e114. doi: 10.1016/j.jemermed.2019.01.031. Epub 2019 Mar 14.

Abstract

Background: Diabetic ketoacidosis (DKA) is a common complication affecting patients with type 1 diabetes, and DKA is associated with dehydration and electrolyte abnormalities. Supraventricular tachycardia (SVT), although a common tachydysrhythmia in the pediatric population, remains a rare entity in patients presenting with DKA.

Case report: We describe a case of first-time SVT in an adolescent patient with DKA and recent methamphetamine abuse, with both factors likely predisposing him to develop a tachydysrhythmia. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: SVT can be present in a patient who has concomitant recent stimulant intake and DKA. A trial of abortive therapy, such as adenosine, should be considered upon diagnosis.

Keywords: arrhythmia; diabetic ketoacidosis; dysrhythmia; methamphetamine; supraventricular tachycardia.

Publication types

  • Case Reports

MeSH terms

  • Adenosine / therapeutic use
  • Anti-Arrhythmia Agents / therapeutic use
  • Diabetic Ketoacidosis / complications*
  • Diabetic Ketoacidosis / physiopathology
  • Fluid Therapy
  • Humans
  • Male
  • Methamphetamine / adverse effects*
  • Tachycardia, Supraventricular / drug therapy
  • Tachycardia, Supraventricular / etiology*
  • Tachycardia, Supraventricular / physiopathology
  • Young Adult

Substances

  • Anti-Arrhythmia Agents
  • Methamphetamine
  • Adenosine