Cardiac complications of protein-sparing modified fasting.

Cardiovascular abnormalities developed in a patient during a protein-sparing modified fasting diet. Syncope was the complaint at the time of examination. Hypotension, persistent QTc interval prolongation, and a low QRS voltage were observed before the development of refractory ventricular tachycardia. At autopsy, antemortem thrombi were attached to the left ventricular endocardium and a fenestrated aortic valvule. Strick protein-sparing modified fasting is not without risk of sudden death even with close medical supervision.