CureusJul 7, 2025

Life-Threatening Heart Rhythm Problems Linked to Severe Stomach Side Effects from High Doses of Tirzepatide

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Jan 20, 2026

Abstract

A 57-year-old woman experienced cardiac arrest after severe gastrointestinal symptoms and electrolyte imbalances while on 15 mg weekly tirzepatide.

Tirzepatide is associated with gastrointestinal side effects that can lead to severe electrolyte imbalances.
The patient developed potassium levels of 2.2, magnesium levels of 1.1, and corrected calcium levels of 5.6, resulting in ventricular fibrillation.
Comprehensive evaluation ruled out obstructive coronary artery disease as a cause of the cardiac arrest.
Following resuscitation, the patient's ejection fraction improved significantly, indicating recovery from the cardiac event.
This case suggests that severe electrolyte disturbances from tirzepatide may increase the risk of life-threatening arrhythmias.

Simplified

Tirzepatide is a long-acting agonist of glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptors, used for the treatment of type 2 diabetes and obesity, and recently approved for obstructive sleep apnea. It is known to cause gastrointestinal (GI) side effects; however, these are generally not severe enough to be life-threatening. We present a unique case of a 57-year-old woman with no prior cardiac history who was on a high dose of tirzepatide (15 mg weekly) for weight loss. After her dose was increased to 15 mg, she developed severe GI symptoms, including prolonged vomiting and diarrhea, leading to profound electrolyte imbalances (K⁺ 2.2, Mg²⁺ 1.1, and corrected Ca²⁺ 5.6) and ultimately resulting in ventricular fibrillation and cardiac arrest. The patient was successfully resuscitated and stabilized with electrolyte correction. A comprehensive evaluation, including left heart catheterization, ruled out obstructive coronary artery disease. Following the cardiac arrest, the patient had severely reduced left ventricular function, likely due to hypoxia and post-cardiac arrest stunning. However, her ejection fraction significantly improved within a few weeks, suggesting that tirzepatide-associated GI side effects and subsequent electrolyte disturbances were the primary precipitating factors. This case highlights a previously undocumented risk of life-threatening arrhythmias due to severe electrolyte disturbances caused by tirzepatide-induced GI side effects. Vigilant electrolyte monitoring is crucial, particularly in patients on high doses or those with additional risk factors.

Full Text

We can’t show the full text here under this license.

View Full Text ↗

Funding

Competing interests

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

PubMed

Life-Threatening Heart Rhythm Problems Linked to Severe Stomach Side Effects from High Doses of Tirzepatide

Abstract

Full Text

Funding

Competing interests

You found one interesting study. We’ll send the next 7.

What Lands in Your Inbox Each Week:

Recent issues from the glp-1 therapies brief

Abstract

Full Text

Funding

Competing interests

Related papers

You found one interesting study. We’ll send the next 7.

What Lands in Your Inbox Each Week:

Recent issues from the glp-1 therapies brief