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Type 1 Brugada pattern electrocardiogram induced by hypokalemia
Thein Swe1, Muhammad Hassan Dogar2
1Department of Internal Medicine, Interfaith Medical Center, New York, USA.
Journal of Family Medicine and Primary Care
|February 21, 2017
Summary
Hypokalemia, or low potassium levels, can unmask Brugada syndrome, a genetic heart condition. Prompt correction of potassium levels can resolve the Brugada electrocardiogram pattern, highlighting the importance of monitoring electrolytes in at-risk patients.
Area of Science:
- Cardiology
- Electrophysiology
- Genetics
Background:
- Brugada syndrome is an inherited arrhythmogenic ion channel disease characterized by coved-type ST-segment elevation in right precordial leads.
- It can lead to ventricular arrhythmias and sudden cardiac death (SCD).
- The association between hypokalemia and the Brugada electrocardiogram (EKG) pattern is rarely reported.
Observation:
- A patient presented with hypokalemia (serum potassium 2.9 mmol/L).
- This was associated with a new right bundle branch block pattern and coved ST-segment elevations with inverted T waves in leads V1-V2, indicative of a Type 1 Brugada EKG pattern.
- The patient's serum potassium was corrected.
Findings:
- Repeated EKG 6 hours after potassium correction revealed the disappearance of the Type 1 Brugada pattern.
- Hypokalemia may unmask a Type 1 Brugada EKG pattern, although no specific serum potassium level is definitively known to induce it.
Implications:
- Physicians should be aware that hypokalemia can unmask Brugada syndrome.
- Patients with a family history of arrhythmia or SCD are at high risk.
- Monitoring electrolytes is crucial in patients with suspected or known Brugada syndrome, especially when presenting with EKG abnormalities.
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