{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T14:07:39Z","timestamp":1789222059258,"version":"build-2803163510"},"reference-count":18,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Pulmonary and Critical Care Medicine"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>Stiff person syndrome (SPS) is a rare autoimmune neurologic disorder that may be accompanied by severe spasms and autonomic instability. We present a man in his 30s with SPS who developed whole-body spasms, severe hypoxemic respiratory failure, and subsequent pulseless ventricular tachycardia\/ventricular fibrillation during an attempted extubation at an outside hospital. Initial evaluation demonstrated hyperthermia, shock, ST-segment depression, markedly elevated troponin, and transient severe left ventricular systolic dysfunction; coronary angiography and computed tomography pulmonary angiography excluded obstructive coronary artery disease and pulmonary embolism. After transfer, electrocardiography showed sinus bradycardia with marked QT\/QTc (corrected QT interval) prolongation, and while the patient was receiving amiodarone, transesophageal echocardiography showed recovery of left ventricular ejection fraction to 51%, and cardiac magnetic resonance imaging showed patchy mid-wall late gadolinium enhancement with increased T1 and T2 signal compatible with clinically suspected myocarditis. Because endomyocardial biopsy was not performed, the cause of the myocardial injury remained uncertain. Severe hypoxemia, possible sepsis-related myocardial dysfunction, acquired QT prolongation and medication effects, autonomic instability, and cardiac magnetic resonance-supported myocarditis were considered potentially interacting contributors. After recurrent non-sustained ventricular tachycardia and a prior ventricular tachycardia\/ventricular fibrillation arrest without a single clearly reversible cause, an implantable cardioverter-defibrillator was placed for secondary prevention. This case illustrates the diagnostic uncertainty surrounding cardiac arrest in SPS and emphasizes the need to evaluate reversible arrhythmic triggers.<\/jats:p>","DOI":"10.1177\/29768675261485672","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T13:56:01Z","timestamp":1789048561000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Unmasking the Connection: Cardiac Arrest in Stiff Person Syndrome"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9109-9231","authenticated-orcid":false,"given":"Saurabh","family":"Sujanyal","sequence":"first","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossny","family":"Alaws","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7590-2293","authenticated-orcid":false,"given":"Scott A","family":"Helgeson","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Mayo Clinic, Jacksonville, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"Cardiac Arrest","author":"Patel K","year":"2024","unstructured":"Patel K, Hipskind JE. Cardiac Arrest. StatPearls Publishing, 2024, http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK534866\/."},{"issue":"6","key":"e_1_3_4_3_2","first-page":"123","article-title":"State-specific mortality from sudden cardiac death\u2013United States, 1999","volume":"51","author":"Centers for Disease Control and Prevention (CDC)","unstructured":"Centers for Disease Control and Prevention (CDC). State-specific mortality from sudden cardiac death\u2013United States, 1999. MMWR Morb Mortal Wkly Rep. 2002 Feb 15;51(6):123\u2013126. https:\/\/pubmed.ncbi.nlm.nih.gov\/11898927\/.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.15420\/aer.2018:15:2"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(82)90443-X"},{"issue":"23","key":"e_1_3_4_6_2","first-page":"2534","article-title":"ACC\/AHA\/HRS 2006 key data elements and definitions for electrophysiological studies and procedures","volume":"114","author":"American College of Cardiology\/American Heart Association Task Force on Clinical Data Standards (ACC\/AHA\/HRS Writing Committee to Develop Data Standards on Electrophysiology); Buxton AE, Calkins H, et al.","unstructured":"American College of Cardiology\/American Heart Association Task Force on Clinical Data Standards (ACC\/AHA\/HRS Writing Committee to Develop Data Standards on Electrophysiology); Buxton AE, Calkins H, et al. ACC\/AHA\/HRS 2006 key data elements and definitions for electrophysiological studies and procedures. Circulation. 2006 Dec 5;114(23):2534\u20132570. https:\/\/pubmed.ncbi.nlm.nih.gov\/17130345\/.","journal-title":"Circulation"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9030848"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2011-000071"},{"key":"e_1_3_4_9_2","volume-title":"StatPearls [Internet]","author":"Muranova A","year":"2024","unstructured":"Muranova A, Shanina E. Stiff person syndrome. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2024. http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK573078\/."},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-018-1232-z"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00315688"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2011.991"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2014-309201"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-009-0013-9"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.09.072"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.10.080"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.12.064"},{"issue":"2","key":"e_1_3_4_18_2","first-page":"183","article-title":"Fulminant myocarditis complicated by stiff-person syndrome: A case report","volume":"4","author":"Chen P","unstructured":"Chen P, Tang N, Zhang H, Wang DW. Fulminant myocarditis complicated by stiff-person syndrome: A case report. Cardiol Discov. 2024 Mar 27;4(2):183\u2013186. https:\/\/journals.lww.com\/cd\/fulltext\/2024\/06000\/fulminant_myocarditis_complicated_by_stiff_person.8.aspx.","journal-title":"Cardiol Discov"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac262"}],"container-title":["Therapeutic Advances in Pulmonary and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29768675261485672","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/29768675261485672","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29768675261485672","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T13:46:12Z","timestamp":1789220772000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/29768675261485672"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":18,"alternative-id":["10.1177\/29768675261485672"],"URL":"https:\/\/doi.org\/10.1177\/29768675261485672","relation":{},"ISSN":["2976-8675","2976-8675"],"issn-type":[{"value":"2976-8675","type":"print"},{"value":"2976-8675","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"article-number":"29768675261485672"}}