Sinus arrest associated with diabetic ketoacidosis regressing to sinus rhythm after compensation of diabetic process: A case report and literature review

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Abstract Background Diabetic ketoacidosis (DKA) is a serious life-threatening condition due to its profound hydro electrolytic disturbances and multiple complications, notably cerebral edema and circulatory collapse. Conductive disorders occurring during its course, such as sinus arrest, are poorly reported and can be life-threatening on their own in the absence of adequate recognition and treatment. Our effort through this report was raising awareness of unusual conduction complications of diabetic ketoacidosis and showing the importance of early diagnosis and treatment. Case presentation we present the case of a middle-aged man with past history of type 2 diabetes whose symptoms included asthenia and consciousness disorder concomitant with ketoacidosis decompensation. Electrocardiogram (ECG) revealed the presence of sinus arrest with ventricular escaping rhythm. The rapid management of the diabetic decompensation resulted in spontaneous return to sinus rhythm, thus avoiding permanent pacing for the patient. Conclusions Atypical complications during ketoacidosis decompensation, such as sinus arrest, are often overlooked and associated with reserved prognosis. Proper recognition and prompt treatment are crucial for optimal outcome.

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