Brugada-Type Pattern on Electrocardiogram Associated with High-Dose Loperamide Abuse

Area of Science:

• Cardiology
• Clinical Toxicology
• Emergency Medicine

Background:

• Loperamide, an over-the-counter medication for diarrhea, is increasingly abused for central nervous system effects.
• High-dose loperamide use is associated with significant risks, including cardiotoxicity.
• Abuse of loperamide can lead to various cardiac complications beyond its intended use.

Observation:

• A case of a 49-year-old male with chronic loperamide abuse presented with new Brugada-like changes on electrocardiogram (ECG).
• The patient had no prior history of Brugada syndrome or similar ECG findings.
• These Brugada-like ECG changes resolved after the patient discontinued loperamide use during hospitalization.

Findings:

• Loperamide abuse can induce Brugada-like ECG abnormalities.
• These ECG changes may be reversible upon cessation of loperamide.
• The absence of other symptoms does not rule out loperamide-induced cardiotoxicity.

Implications:

• Emergency physicians must consider loperamide abuse in patients presenting with unexplained cardiac abnormalities, particularly Brugada-like ECG changes.
• Prompt recognition and management of loperamide cardiotoxicity are crucial.
• Awareness of this association can prevent misdiagnosis and ensure appropriate patient care.