1.A Rare Presentation of a Common Disorder : Severe Hyponatremia Presenting as Reversible Unstable Bradyarrythmias
Ahmad Luqman Md Pauzi ; Norhayati Mohamad Amin ; Adi Putera Sazali ; Juliana Hashim ; Muhammad Afif Abdullah ; Iskasymar Ismail ; Wan Zulhaikal Wan Zukiman
Malaysian Journal of Medicine and Health Sciences 2024;20(No.1):395-397
Severe hyponatraemia is defined as a sodium level of less than 120 mEq/L, and it is frequently accompanied by
neurological symptoms like coma, convulsions, respiratory arrest, and death. Clinical cardiac toxicity from hyponatremia, such as bradyarrhythmia, is extremely rare. In this article, we present a case of acute severe hyponatraemia
that induced unstable bradyarrhythmia and led to refractory bradycardia, which did not improve despite receiving
treatment in accordance with the standard Advanced Cardiovascular Life Support protocol. The patient’s bradyarrhythmia has completely resolved with the administration of 3% hypertonic saline, which restored her sodium
levels. Due to the possibility that severe hyponatremia may contribute to the aetiology of cardiac malfunction, this
case raises awareness about the significance of closely monitoring electrocardiograms and telemetry in patients with
severe hyponatremia.