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Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
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Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
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Updated: Jun 18, 2025

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Brugada Phenotype Following a Cocaine Overdose.

Ammar F Chauhdri1,2, Patrick Bruss1, Alvin Tran1

  • 1Emergency Medicine, ProMedica Monroe Regional Hospital, Monroe, USA.

Cureus
|August 5, 2024
PubMed
Summary

Cocaine use can induce Brugada-like electrocardiogram patterns, mimicking Brugada syndrome. This case highlights the importance of distinguishing drug-induced changes from true Brugada syndrome for proper patient management.

Keywords:
brugada syndromebrugada type 1cardiotoxicitycocaineconnexin 43ecgelectrolyte abnormalitysodium channels

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Area of Science:

  • Cardiology
  • Clinical Electrophysiology
  • Toxicology

Background:

  • Brugada syndrome is a genetic cardiac condition linked to SCN5A mutations, causing fatal arrhythmias.
  • Acquired Brugada syndrome can be triggered by various factors, including illicit drug use.
  • Cocaine is known to affect cardiac ion channels and cellular communication.

Observation:

  • A 31-year-old female presented with unresponsiveness after cocaine use.
  • She developed type 1 Brugada ECG patterns, incomplete right bundle branch block, ST elevations, and repolarization abnormalities.
  • These changes occurred while in the intensive care unit.

Findings:

  • Cocaine use can precipitate Brugada-like electrocardiogram findings.
  • The drug's sodium channel blocking properties and potential effects on connexin 43 may contribute to these cardiac effects.
  • Differentiating drug-induced ECG changes from true Brugada syndrome is crucial.

Implications:

  • Managing drug-induced Brugada-like findings requires careful consideration of patient history and toxicology.
  • Further research is needed to elucidate the precise mechanisms of cocaine's cardiac toxicity.
  • Accurate diagnosis is essential for appropriate patient care and risk stratification.