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Pericarditis mimicking Brugada syndrome
Manuel Monti1, Giulia Olivi1, Francesca Francavilla1
1Emergency Department - USL UMBRIA1, Via V. Muller 1, Assisi, Perugia, Italy.
Insights
Pericarditis, an inflammation of the heart
Area of Science:
- Cardiology
- Electrophysiology
- Internal Medicine
Background:
- Brugada syndrome (BrS) is a genetic disorder affecting cardiac ion channels, leading to arrhythmias.
- Pericarditis is the inflammation of the pericardium, often idiopathic or viral, presenting with chest pain and ECG abnormalities.
- Widespread ST segment changes in pericarditis can involve the epicardium, potentially mimicking other cardiac conditions.
Introduction:
Brugada syndrome (BrS) is a genetic heart disorder due to alteration of the ion channels function that causes an impaired in the cardiac conduction system. It is characterized by an abnormal electrocardiogram pattern and may be complicated by malignant ventricular arrhythmias. Pericarditis is an inflammation of the pericardium and 90% of isolated cases of acute pericarditis are idiopathic or viral. Acute pericarditis may appears with chest pain, fever, pericardial friction rub, and cardiac tamponade. Moreover, widespread ST segment changes occur due to involvement of the underlying epicardium.
Case Report:
A 27-year-old man was admitted to the Emergency Department of the …. Hospital due to fatigue and chest discomfort. Laboratory findings showed that WBC count and C-reactive protein were increased. Echocardiographic finding was normal. The patient was admitted with a diagnosis of pericarditis. Electrocardiogram (ECG) showed a "saddle back"-type ST elevation in leads V2, recognised as type 2 Brugada pattern. The ECG normalized within a few days after the beginning of anti-inflammatory therapy and the follow-up was uneventful. Based on findings in our patient and data from literature, we hypothesize that the patient developed a Brugada ECG pattern due the pericarditis.
Conclusions:
Our case report shows that the pericarditis may mimic BrS. Moreover, it is important to underline that a Brugada ECG pattern should only be considered as a sign of electrical heart disease but detailed diagnostic tests are anyway needed.
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