Hyperkalemia mimicking brugada pattern in electrocardiogram: A rare case report from Nepal

Hyperkalemia is one of the dangerous complications of renal impairment (acute kidney injury or chronic kidney disease). Hyperkalemia may present with the electrocardiogram (ECG) changes as nonspecific repolarization abnormalities. Here, we report a case of AKI with hyperkalemia and the Brugada pattern of ECG, which reverted to normal after effective management of hyperkalemia. A 55-year-old male reported to the Emergency Department of National Academy of Medical Sciences (Bir Hospital) with injuries in his lower limbs and spine after he had met an accident two days back. He also had decreased urine output for the last one day. On physical examination, he had injuries in the spine and lower limbs. His laboratory investigations showed impaired renal function parameters with serum sodium 130 mEq/L and serum potassium of 7.3 mEq/L. His ECG was consistent with Brugada pattern. Patient was treated with 10% calcium gluconate, insulin and dextrose, salbutamol nebulization, and sodium polystyrene sulfonate till hemodialysis was initiated. Hyperkalemia and acidosis can manifest with the Brugada pattern in ECG. Thus, a careful evaluation of hyperkalemia and its treatment must be instituted in such an ECG pattern.