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63 Possible Causes for Cardiac Arrhythmia, Lethargy, Persistent Lactic Acidosis

  • Acidosis

    Respiratory acidosis:Presenting signs can include lethargy or fatigue, shortness of breath, confusion and sleepiness.[symptoma.com] Hyperlactatemia is defined as a persistent, mild to moderate (2-4 mmol/L) increase in blood lactate concentration without metabolic acidosis , whereas lactic acidosis is characterized[emedicine.medscape.com] In mild cases the symptoms may be overlooked; in severe cases symptoms are more obvious and may include muscle twitching, involuntary movement, cardiac arrhythmias, disorientation[medical-dictionary.thefreedictionary.com]

  • Cardiogenic Shock

    In the acute setting, this will typically manifest as a change in mental status (lethargy, decreased responsiveness, agitation, decreased cap refill, cool extremeties etc.[rebelem.com] lactic acidosis, low cardiac output, high doses of catecholamines, kidney and/or liver failure) and of cardiac arrest without “no flow” in patients with advanced chronic[annalsofintensivecare.springeropen.com] Carditis can complicate Lyme disease in an estimated 5% of cases, and cardiogenic shock and severe cardiac arrhythmias are described with electrocardiographic abnormalities[ncbi.nlm.nih.gov]

  • Hypoglycemia

    Signs and symptoms include tachypnea, respiratory distress, tachycardia or bradycardia, lethargy, and seizures 775.6 Excludes infant of mother with diabetes mellitus ( 775.0[icd9data.com] Nocturnal hypoglycemia has been associated with cardiac arrhythmias resulting in sudden death[ 73 ].[doi.org] Glucose screening is also recommended for infants with clinical signs consistent with hypoglycemia: Tremors, jitteriness, irritability Exaggerated Moro reflex High pitched cry Lethargy[med.stanford.edu]

  • Cardiomyopathy

    Infants with this disease may have: Fast and heavy breathing with feedings Feedings that take longer than normal Sweating with feedings Lethargy or inactivity Poor weight[cincinnatichildrens.org] acidosis, severe lactic acidosis, expansion and hypertrophic cardiomyopathy.[ncbi.nlm.nih.gov] INTRODUCTION: Noncompaction cardiomyopathy is a rare phenotype of cardiomyopathy associated with severe cardiac arrhythmia and thromboembolic complications.[ncbi.nlm.nih.gov]

  • Sepsis

    CASE PRESENTATION: A term male infant presented on day 4 of post-natal life with the complaint of decreased appetite, fast respiration and lethargy.[ncbi.nlm.nih.gov] However, in patients with persistently elevated lactate without evidence of inadequate oxygen delivery, type B lactic acidosis should be considered.[ncbi.nlm.nih.gov] Norepinephrine was associated with lower risk for major adverse events and cardiac arrhythmias compared to dopamine.[doi.org]

  • Liver Cirrhosis

    Symptoms Asterixis EEG abnormal Grade 1 Mild confusion, disordered sleep, slurred speech, shortened attention span, euphoria or depression Yes/No No Grade 2 Lethargy, inappropriate[dx.doi.org] Despite stable hemodynamics, lactic acidosis still persisted, and linezolid therapeutic drug monitoring was ordered.[ncbi.nlm.nih.gov] It is performed in a vascular catheterisation laboratory with videofluoroscopy equipment and cardiac monitoring because of the risk of cardiac arrhythmia as the catheter passes[dx.doi.org]

  • Barth Syndrome

    Skeletal (mostly proximal) myopathy causes delayed motor milestones, hypotonia, severe lethargy or exercise intolerance.[orpha.net] BTHS can also present as sudden cardiac death within families, as illustrated by a previous family history of sudden cardiac death in two BTHS patients with documented arrhythmias[ncbi.nlm.nih.gov] Other features include growth delay, muscle weakness, lethargy, fatigue, delayed motor milestones, poor feeding, hypoglycaemia (low blood sugar), lactic acidosis (excess lactic[contact.org.uk]

  • Hypovolemic Shock

    Vasodilation Loss of electrolytes like sodium Pregnancy-associated conditions Severe diarrhea and vomiting Symptoms Symptoms and signs may include: Light headedness Dizziness and lethargy[symptoma.com] lactic acidosis, low cardiac output, high doses of catecholamines, kidney and/or liver failure) and of cardiac arrest without “no flow” in patients with advanced chronic[annalsofintensivecare.springeropen.com] Complications include infection, thrombosis, cardiac arrhythmia, entrapped guide wire, and malposition.[ncbi.nlm.nih.gov]

  • Septicemia

    Clinical presentations were lethargy (96%), respiratory distress (80%) and bleeding diathesis (16%). Absolute neutrophil count The Author [2015].[ncbi.nlm.nih.gov] Lactic acidosis (with no other possible etiologies of lactatemia) would have indicated sepsis.[icd10monitor.com] Norepinephrine was associated with lower risk for major adverse events and cardiac arrhythmias compared to dopamine.[doi.org]

  • Leigh's Disease

    A 7-month-old boy presented clinically with vomiting, lethargy, respiratory difficulty, deteriorated consciousness, and hypotonia.[ncbi.nlm.nih.gov] All children developed progressive neurological deterioration and persistent metabolic lactic acidosis, which was treated with sodium bicarbonate, and the 1st patient needed[ncbi.nlm.nih.gov] Symptoms – Infantile: Reye-like syndrome, enlarged liver, hypoglycemia, enlarged heart, and cardiac arrhythmia. Causes: Autosomal recessive.[umdf.org]

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