| Journal: | Revista médica de Chile |
| Database: | PERIÓDICA |
| System number: | 000454965 |
| ISSN: | 0034-9887 |
| Authors: | Sepúlveda, Rodrigo A1 Romero, Javier2 Sepúlveda, Sebastián3 Juanet, Cristián1 |
| Institutions: | 1Pontificia Universidad Católica de Chile, Facultad de Medicina, Santiago de Chile. Chile 2Centro de Salud Mental Quilicura, Santiago de Chile. Chile 3Hospital Padre Hurtado, Servicio de Cirugía, Santiago de Chile. Chile |
| Year: | 2022 |
| Volumen: | 150 |
| Number: | 4 |
| Pages: | 554-558 |
| Country: | Chile |
| Language: | Español |
| Document type: | Artículo |
| Approach: | Caso clínico |
| English abstract | Severe respiratory alkalosis is a life-threatening condition, as it induces hypo- calcaemia and extreme adrenergic sensitivity leading to cerebral and myocardial vasoconstriction. We report a 37-year-old woman with previous consultations for a conversion disorder. While she was infected with SARS-CoV-2 (without pulmonary involvement), she consulted in the emergency room due to panic attacks. On admission, she developed a new conversion crisis with progressive clinical deterioration, hyperventilation, and severe respiratory alkalosis (pH 7.68, Bicarbonate 11.8 mEq/L and PaCO2 10 mmHg). Clinically, she was in a coma, with respiratory and heart rates 55 and 180 per min, a blood pressure of 140/90 mmHg, impaired perfusion (generalized lividity, distal coldness, and severe skin mottling) and tetany. She also had electrocardiographic changes and high troponin levels suggestive of ischemia, and hyperlactatemia. She was managed in the hospital with intravenous benzodiazepines. The clinical and laboratory manifestations resolved quickly, without the need for invasive measures and without systemic repercussions |
| Disciplines: | Medicina |
| Keyword: | Neumología, Alcalosis respiratoria, COVID-19, Trastorno conversivo, Isquemia miocárdica |
| Keyword: | Pneumology, Respiratory alkalosis, Conversion disorder, COVID-19, Myocardial ischemia |
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