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Brugadaphobia
Laszlo Littmann1, William C Bock2
1Department of Internal Medicine, Atrium Health Carolinas Medical Center, Charlotte, NC, USA.
Insights
Cocaine intoxication can cause a temporary Brugada pattern on ECGs in asymptomatic individuals. This case highlights "brugadaphobia," the unfounded fear of sudden cardiac death, and the challenges in managing such patients.
Area of Science:
- Cardiology
- Clinical Toxicology
Background:
- Brugada pattern on electrocardiograms (ECGs) is associated with an increased risk of sudden cardiac death.
- Cocaine use is known to cause various cardiovascular complications.
- The Brugada pattern can be transient and induced by certain factors.
Abstract:
We present the case of a young man with cocaine intoxication whose electrocardiogram (ECG) on presentation showed a typical type 1 Brugada pattern. The patient had no personal or family history of unexplained syncope or sudden cardiac death. The ECG quickly normalized, and follow-up ECGs continued to be normal. Nevertheless, the patient and family members insisted on implantation of a cardioverter-defibrillator. The purpose of this case report is to discuss the somewhat unfounded fear of sudden cardiac death of asymptomatic patients with Brugada-type ECGs that has been termed "brugadaphobia" and to highlight the difficult and controversial decision-making process that should include discussions about the possible benefits and harms of an overly active diagnostic and therapeutic approach.
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