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2017 ; 2017
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Near death by milk of magnesia
#MMPMID28325719
Alaini A
; Roldan CA
; Servilla K
; Colombo ES
BMJ Case Rep
2017[Mar]; 2017
(ä): ä PMID28325719
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We report a case of hypermagnesemia associated with the use of milk of magnesia
in a male patient with end-stage renal disease. After experiencing nausea and
vomiting, he developed severe bradycardia and then asystole. Resuscitation
efforts were successful; however, he developed atrial fibrillation with severe
widening of the QRS and diffuse ST elevation, hypothermia, hypotension and apnoea
requiring intubation. Initial diagnoses included ST-elevation myocardial
infarction, cardiogenic and/or septic shock and hyperkalaemia. However, serum
magnesium was later found to be >4.1?mmol/L (equivalent to >10?mg/dL). He
underwent haemodialysis (HD) to remove serum magnesium with remarkable overall
improvement. Severe hypermagnesemia can manifest with severe bradycardia and
asystole, shock, hypothermia and respiratory failure and can mimic acute coronary
syndromes complicated with cardiogenic shock or septic shock. Therefore,
clinicians should be aware of this life-threatening condition in patients with
significant renal dysfunction. Timely treatment with HD is highly effective and
lifesaving.