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May 1978

Magnesium Deficiency as a Cause of Serious Arrhythmias

Arch Intern Med. 1978;138(5):825. doi:10.1001/archinte.1978.03630290105039

To The Editor.—  I read with interest the article by Fisher and Abrams on ventricular tachyarrhythmias in delirium tremens. Serious arrhythmias occur fairly often in the alcohol withdrawal syndrome. Sudden death of patients with the alcohol withdrawal syndrome is undoubtedly usually owing to tachyarrhythmias. The authors summarize the important literature on this subject.Several features of the report deserve particular attention. The dose of magnesium was only 1.5 g of MgSO4 • 7H2O (12 mEq). In studies of patients with the alcohol withdrawal syndrome in our laboratory the average positive balance during recovery was 1.0 mEq/kg, and there was a significant decrease in muscle magnesium, potassium, and phosphate concentrations.1 The dose that is usually needed for treatment of magnesium deficiency of any cause, therefore, is much larger than the amount given in the above-mentioned report. Extensive experience with a schedule that gives about 1.0 mEq/kg on

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