Brugada pattern mimicking acute coronary syndrome in a febrile state
Aneesh Pakala1, Tarun W Dasari, Karen J Beckman
1Department of Internal Medicine, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Blvd., WP 1130, Oklahoma City, Oklahoma 73104, USA. aneesh-pakala@ouhsc.edu
Abstract:
The Brugada type pattern is characterized by a coved or saddleback shaped ST-segment elevation in the right precordial leads (V1-V3) on a surface 12 lead electrocardiogram (ECG). This pattern can be seen spontaneously, induced by sodium channel blocking drugs or rarely by hyperthermia. The mechanism is secondary to an alteration in the sodium channels induced by a febrile state. Such ECG's could easily be mistaken for acute ST segment elevation myocardial infarction and thus pose a unique clinical challenge to emergency room physicians. We report such a case of fever induced Brugada pattern and discuss the underlying mechanisms.
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