Kramer et al have reported cardiac dysfunction in a young adult who presented with HOKPP with increased myocardial fraction of CPK (myocardial band), alteration in the lactic dehydrogenase isoenzyme pattern, severe bradycardia and decreased left ventricular dysfunction.13 There have been other reports of arrhythmias with Thyrotoxic variety of HOKPP. This evidence concerns the gene PIK3C2A and hypokalemic periodic paralysis.