Hyperinsulinism in a child presenting with cardiac ischemia and bradycardia

A 5-year-old boy referred to our service with suspected sinus node dysfunction. in addition to the arrhythmia,he had moderate mitral valve regurgitation and depressed ventricular function during a hypoglycemic episode. cardiac abnormalities resolved with glucose infusion. we believe that hypoglycemia was responsible for the cardiac manifestations and it should be considered in unexplained rhythm disturbances or ischemia. © 2014.