This case involves a young woman sent from a psychiatric hospital to the emergency department for assessment. Her chief complaint is intermittent shortness of breath. According to the psychiatrist’s note, she has experienced frequent episodes of uncontrollable hyperventilation, associated with carpopedal spasm and loss of consciousness in the past. There is concern she may have a chest infection. A chest X-ray appears to exclude a chest infection as an explanation of her symptoms, and arrangements are made to transfer her back to the psychiatric facility with a diagnosis of exacerbation of anxiety state. Unexpectedly, there is a sudden deterioration in the patient’s condition, which proves fatal.
Spontaneous bilateral carpopedal spasm in a bulimic patient
