JP. Machiels, A. Dive, J. Donckier and E. Installé (1998). Reversible myocardial dysfunction in a patient with alcoholic ketoacidosis: a role for hypophosphatemia. The American journal of emergency medicine, 16(4), 371-3. https://doi.org/10.1016/s0735-6757(98)90130-9

PubMed 9672453

[Abstract]
A 39-year-old woman had alcoholic ketoacidosis complicated by reversible life-threatening myocardial dysfunction. This complication occurred a few hours after correction of acidosis in association with severe hypophosphatemia. A marked improvement in clinical, echocardiographic, and hemodynamic features was associated with the normalization of the serum phosphorus level. This case illustrates a rare complication of hypophosphatemia, emphasizing the need for emergency physicians to consider this metabolic disorder in the treatment of patients with alcoholic ketoacidosis. The pathogenesis of hypophosphatemia in alcoholic ketoacidosis, its potential role in myocardial dysfunction, and its therapeutic implications in emergencies are discussed.