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长期使用非处方质子泵抑制剂导致的低镁血症可能是室上性心动过速的一个病因。

Hypomagnesemia Caused by Chronic Use of Over-the-Counter Proton Pump Inhibitor as a Possible Cause of Supraventricular Tachycardia.

作者信息

Ortega Francisco J, Campos Frederick N, Mercedes Branidia

机构信息

Internal Medicine, Wyckoff Heights Medical Center, Brooklyn, USA.

出版信息

Cureus. 2023 Jul 28;15(7):e42606. doi: 10.7759/cureus.42606. eCollection 2023 Jul.

Abstract

Magnesium is an important co-factor that helps regulates the movement of ions through voltage-mediated channels within myocardial tissues by the membrane sodium-potassium pump, and its deficiency can reduce the pump's activity, leading to partial depolarization and changes in the activity of many potential-dependent membrane channels leading to arrhythmias. In this case report, we are looking to establish the direct relationship between hypomagnesemia caused by proton pump inhibitors (PPIs), which could lead to cardiac arrhythmias. Here, we present a 45-year-old Hispanic female, with a known past medical history of supraventricular tachycardia (SVT), hiatal hernia on proton pump inhibitor (PPI), and chronic smoking, who presented to the emergency department complaining of dizziness and palpitations that started two hours prior arrival to the hospital. At triage, the patient was found to have a heart rate of 190 beats per minute (bpm), and an electrocardiogram (EKG) revealed supraventricular tachycardia with a heart rate of 185 bpm. During the review of this case, no other confounding factors besides hypomagnesemia were noted, leaving this one to be the most likely cause of the arrhythmia. Patients on long-term PPI therapy are at higher risk of developing hypomagnesemia, which could lead to cardiac arrhythmia.

摘要

镁是一种重要的辅助因子,它通过膜钠钾泵帮助调节离子通过心肌组织中电压介导通道的运动,其缺乏会降低泵的活性,导致部分去极化以及许多电位依赖性膜通道活性改变,进而引发心律失常。在本病例报告中,我们旨在确立质子泵抑制剂(PPI)所致低镁血症与可能导致心律失常之间的直接关系。在此,我们报告一名45岁的西班牙裔女性,她有室上性心动过速(SVT)、质子泵抑制剂治疗的食管裂孔疝病史以及长期吸烟史,因在入院前两小时开始出现头晕和心悸而就诊于急诊科。在分诊时,发现患者心率为每分钟190次(bpm),心电图(EKG)显示室上性心动过速,心率为185 bpm。在对该病例的回顾中,除低镁血症外未发现其他混杂因素,因此低镁血症最有可能是心律失常的原因。长期接受PPI治疗的患者发生低镁血症的风险更高,这可能导致心律失常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfea/10460536/fe95de8d4dba/cureus-0015-00000042606-i01.jpg

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