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Brugada pattern electrocardiographic changes associated with profound electrolyte disturbance.
Jason C Kovacic1, Dennis L Kuchar
1Cardiology Department, St. Vincent's Hospital, Darlinghurst, Sydney, Australia. jkovacic@netline.net.au
Pacing and Clinical Electrophysiology : PACE
|July 24, 2004
Summary
Diabetic ketoacidosis can cause Brugada pattern ECG changes. Electrophysiological studies confirmed no underlying Brugada syndrome in this case.
Area of Science:
- Cardiology
- Electrophysiology
- Endocrinology
Background:
- Brugada pattern electrocardiogram (ECG) changes are rare with electrolyte disturbances.
- Previous reports often lack rigorous exclusion of underlying Brugada syndrome.
Observation:
- A 38-year-old man with diabetic ketoacidosis presented with significant electrolyte abnormalities and Brugada pattern ECG changes.
- The patient was otherwise healthy without a prior history of cardiac events or Brugada syndrome.
Findings:
- Electrolyte disturbance, specifically diabetic ketoacidosis, induced transient Brugada pattern ECG changes.
- Pharmacological challenge with flecainide and electrophysiological studies definitively excluded an underlying Brugada syndrome.
Implications:
- This case highlights the importance of considering metabolic disturbances in the differential diagnosis of Brugada pattern ECG.
- It underscores the need for comprehensive electrophysiological evaluation to differentiate transient changes from true Brugada syndrome.