당뇨병성 케톤산증 환자는 QT 간격 연장, 그리고 이에 따른 Torsades de Pointes 발생 위험의 위험요소를 많이 내포하고 있으며 실제로 치명적인 부정맥인 Torsades de Pointes, 그리고 그에 따른 심정지를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Diabetic ketoacidosis (DKA) is an acute complication related to severe hyperglycemia. While the mortality rate for DKA is low with appropriate therapy, several complications may lead to deterioration of the clinical course. Here, we report a case of a 23-year-old patient with DKA who suffered from a rare but hemodynamically unstable cardiac arrhythmia, polymorphic ventricular tachycardia with prolonged QT interval, or Torsades de Pointes. During the recovery phase of DKA, three episodes of Torsades de Pointes suddenly occurred, and were recovered by immediate defibrillation. The patient did not have structural heart disease or a genetic predisposition. To the best of our knowledge, this is the first report of an adult with DKA complicated with QT prolongation related to Torsades de Points after correction of ketosis. To manage DKA, more attention may be needed on changes in the QT interval as well as risk factors for Torsades de Points. (Korean J Med 2021;96:432-437)