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September 1977

Syncope as a Manifestation of Primary Aldosteronism

Arch Intern Med. 1977;137(9):1260. doi:10.1001/archinte.1977.03630210126038

To the Editor.—  We recently encountered a case of primary aldosteronism in which the patient had syncopal attacks, the cause of which was attributable to ventricular tachyarrythmia that was due to hypopotassemia.

Report of a Case.—  A 27-year-old woman was admitted to Tokyo Medical and Dental University Hospital in September 1975 because of syncopal attacks. She had experienced the first attack four years ago. Two years later the second attack occurred and an arrhythmia was detected. Immediately before admission, the third attack of about five minutes' duration accompanied by tonic seizures occurred when she was awakened by the telephone.On admission her blood pressure was 210/110 mm Hg. An ECG showed ventricular tachyarrythmia (Figure). The ECG findings recorded during sinus rhythm were consistent with hypopotassemia (2.8 mEq/liter).Primary aldosteronism was diagnosed from the following data: potassium clearance rate with sodium thiosulfate loading, 54.5 ml/min (normal, 18.1 ± 2.0 ml/min); decreased

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