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Beer, hyponatraemia and cardiac conduction defects
  1. Simon Mifsud1,
  2. Emma Louise Schembri1,
  3. Matthew Mercieca Balbi2,
  4. Mark Gruppetta3,
  5. James Clark1
  1. 1Department of Medicine, Mater Dei Hospital, Msida, Malta
  2. 2Department of Cardiology, Mater Dei Hospital, Msida, Malta
  3. 3Department of Diabetes and Endocrinology, Mater Dei Hospital, Msida, Malta
  1. Correspondence to Dr Simon Mifsud, mifsudsimon{at}


The authors report a case of a 68-year-old man who was diagnosed with an irreversible second-degree atrioventricular (AV) Mobitz II 2:1 block temporally associated with profound hyponatraemia. The cause of the hyponatraemia was beer potomania. The co-occurrence of reversible first, second and third-degree heart blocks and hyponatraemia has been described in a few published case reports. However, this case is noteworthy as the AV block persisted, despite correction of serum sodium concentration as opposed to other published cases, which meant that the patient required a permanent pacemaker.

  • endocrinology
  • medical management
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  • Contributors SM and ELS were responsible for literature review and manuscript preparation. MMB, MG and JC contributed towards editing and review of the final manuscript.

  • Funding The authors declare that they have not receieved any specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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