Hyperkalemia-induced Brugada pattern: an unusual manifestation

Area of Science:

• Cardiology
• Electrophysiology
• Genetics

Background:

• Brugada syndrome is an inherited cardiac channelopathy characterized by a specific electrocardiographic (ECG) pattern and increased risk of sudden cardiac death.
• The Brugada electrocardiographic pattern (BrP) can be mimicked by various conditions, including electrolyte disturbances, making diagnosis challenging.

Observation:

• This report details a rare case where severe hyperkalemia induced a Brugada type I electrocardiographic pattern.
• Notably, the patient did not exhibit other characteristic ECG findings typically associated with hyperkalemia, such as peaked T waves or loss of P waves.

Findings:

• Hyperkalemia can present with a Brugada type I pattern, a finding not previously well-documented.
• The absence of typical hyperkalemia ECG manifestations in this case underscores the complexity of ECG interpretation in electrolyte imbalances.

Implications:

• This case broadens the differential diagnosis for the Brugada electrocardiographic pattern, emphasizing the need to consider hyperkalemia.
• Clinicians should be aware of this potential ECG mimicry to avoid misdiagnosis and ensure appropriate management of both hyperkalemia and potential underlying cardiac conditions.