A Perfect Storm: A Case of Transient Brugada Pattern

Gin Den William Chang^1, , Christabel Nyange¹, Sana Ahmad¹, Prateek Baghel¹, Elizabeth Brown¹, Sandrine Lebrun¹ and Nicholas Skipitaris¹

¹Northwell Lenox Hill Hospital

Cite this paper

Gin Den William Chang, Christabel Nyange, Sana Ahmad, Prateek Baghel, Elizabeth Brown, Sandrine Lebrun and Nicholas Skipitaris. A Perfect Storm: A Case of Transient Brugada Pattern. American Journal of Medical Case Reports. 2020; 8(11):424-427. doi: 10.12691/AJMCR-8-11-12

Abstract

Brugada syndrome is a known electrophysiological phenomenon associated with high risk of sudden cardiac death. However, there are a number of published case reports showing a Brugada pattern in patients due to an underlying agent or cause. This case provides the nearly ideal clinical setup for a patient presenting with electrocardiographic findings of Brugada due to multiple factors requiring treatment of the underlying causes without need for further long term interventions.

Keywords

Brugada syndrome, transient Brugada

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Morita H, Zipes DP, Wu J. Brugada syndrome: insights of ST elevation, arrhythmogenicity, and risk stratification from experimental observations. Heart Rhythm. (11 Suppl): S34-S43. 2009.
[2]	Dumaine R, Towbin JA, Brugada P, et al. Ionic mechanisms responsible for the electrocardiographic phenotype of the Brugada syndrome are temperature dependent. Circ Res. 85:803-809. 1999.
[3]	Adler A, Topaz G, Heller K, et al. Fever-induced Brugada pattern: how common is it and what does it mean?. Heart Rhythm. 10(9): 1375-1382. 2013.
[4]	Manohar S, Dahal BR, Gitler B. Fever-Induced Brugada Syndrome. J Investig Med High Impact Case Rep. 2015; 3(1): 2324709615577414. Mar 23, 2015.
[5]	Dumaine R, Towbin JA, Brugada P, et al. Ionic mechanisms responsible for the electrocardiographic phenotype of the Brugada syndrome are temperature dependent. Circulation Res. 85: 803-809. 1999.
[6]	Barajas-Martínez HM, Hu D, Cordeiro JM, et al. Lidocaine-induced Brugada syndrome phenotype linked to a novel double mutation in the cardiac sodium channel. Circ Res. 103(4): 396-404. 2008.
[7]	Akhtar M, Goldschlager NF. Brugada electrocardiographic pattern due to tricyclic antidepressant overdose. J Electrocardiol. 39(3): 336-339. 2006.
[8]	Otero D, Lopez Persio, Calderon EC, Kiss J, Liao, S. Brugada Pattern: An Unusual Presentation of tricyclic antidepressant overdose. J Am Coll Cardiol. 3 (9 Supplement 1) 2666. March 2019.
[9]	Weiner JB, Haddad EV, Raj SR. Recovery following propofol-associated brugada electrocardiogram. Pacing Clin Electrophysiol. 33(4): e39-e42. 2010.
[10]	Junttila MJ, Gonzalez M, Lizotte E, et al. Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. Circulation. 117(14): 1890-1893. 2008.
[11]	Phillips N, Priestley M, Denniss AR, Uther JB. Brugada-type electrocardiographic pattern induced by epidural bupivacaine. Anesth Analg. 97(1). 2003.
[12]	Littmann L, Monroe MH, Svenson RH. Brugada-type electrocardiographic pattern induced by cocaine. Mayo Clin Proc. 75: 845-849. 2000.
[13]	Achaiah A, Andrews N. Intoxication with alcohol: An underestimated trigger of Brugada syndrome? JRSM Open. 2016; 7(5): 2054270416640153. May 3, 2016.
[14]	Kimie Ohkubo, Toshiko Nakai, Ichiro Watanabe, Alcohol-induced ventricular fibrillation in a case of Brugada syndrome, EP Europace, Volume 15, Issue 7, Page 1058. July 2013.
[15]	Kariyanna PT, Jayarangaiah A, Hegde S, et al. Marijuana Induced Type I Brugada Pattern: A Case Report. Am J Med Case Rep. 6(7): 134-136. 2018.
[16]	Rambod M, Elhanafi S, Mukherjee D. Brugada phenocopy in concomitant ethanol and heroin overdose. Ann Noninvasive Electrocardiol. 20(1): 87-90. 2015.
[17]	Ozyilmaz I, Bedir A, Ergul Y. Sudden Cardiac Arrest While Eating a Hot Dog: A Rare Presentation of Brugada Syndrome in a Child. Pediatrics. Oct 2017.
[18]	Teodorovich N, Kogan Y, Paz O, Swissa M. Vagally mediated ventricular arrhythmia in Brugada syndrome. HeartRhythm Case Rep. 2016; 2(6): 530-535. Sep 12, 2016.
[19]	Cole, Jon B et al. “Isolated tramadol overdose associated with Brugada ECG pattern.” Pacing and clinical electrophysiology: PACE 35 8. 2012.
[20]	Al-Khatib S.M., Stevenson W.G., Ackerman M.J., et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 72: e91-e220. Aug 1, 2018.