A dynamic Brugada sign due to left anterior descending coronary artery occlusion

Area of Science:

• Cardiology
• Electrophysiology
• Medical Diagnostics

Background:

• Brugada phenocopies (BrP) present an electrocardiographic (ECG) pattern similar to Brugada syndrome (BrS).
• Distinguishing BrP from true Brugada syndrome is crucial for appropriate patient management.
• Acute myocardial infarction (AMI) is a potential cause of BrP.

Observation:

• This report describes two cases of AMI that manifested as BrP.
• In cases of AMI-induced BrP, occlusion of the right coronary artery (RCA) is most commonly implicated.
• Less frequently, the left anterior descending artery (LAD) has been identified as the culprit vessel.

Findings:

• In both presented cases, the LAD was identified as the occluded artery causing the BrP.
• These findings highlight the LAD as a potential, albeit rare, cause of AMI-related BrP.
• The ECG findings in these AMI patients were indistinguishable from classical Brugada syndrome.

Implications:

• Recognizing AMI as a cause of BrP is vital for timely diagnosis and treatment.
• The LAD artery should be considered in the differential diagnosis of BrP, especially in AMI patients.
• This underscores the importance of comprehensive etiological investigation for patients presenting with BrP patterns.