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Fever-Induced Brugada-Pattern Electrocardiogram
Rahul V Nene1, Vaishal M Tolia1
1Department of Emergency Medicine, University of California-San Diego, San Diego, California.
Background:
Brugada syndrome is an increasingly recognized syndrome characterized by a particular electrocardiography (ECG) pattern and clinical criteria and has a high incidence of sudden death in patients with structurally normal hearts. The Brugada ECG pattern can be unmasked by drugs, ischemia, and fever.
Case Report:
We present the case of a 47-year-old man who presented to the emergency department with flu-like symptoms and syncope. On arrival, he was febrile and his ECG showed a Brugada pattern. Although this pattern resolved once his fever resolved, the cardiologists were concerned that his syncopal episode might have been due to ventricular tachycardia/fibrillation, and the patient was admitted for implantable cardiac defibrillator placement. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Fever and other stressors can unmask a Brugada pattern on ECG, and if patients have concerning clinical criteria, they should receive emergent cardiology follow-up.
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