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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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COVID-19-induced Brugada phenocopy pattern in a patient with previous myocardial infarction: A case report

Lijiang Ding1, Huayong Jin

  • 1Department of Electrocardiology, Shaoxing People's Hospital, School of Medicine, Shaoxing University, Shaoxing, Zhejiang Province, China.

Medicine
|December 30, 2025
PubMed

Insights

Coronavirus disease 2019 (COVID-19) can mimic heart attacks with electrocardiogram (ECG) changes. Prompt treatment of fever and specific ECG analysis are key to diagnosing and managing COVID-19-induced Brugada phenocopy, preventing misdiagnosis.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Diagnostics

Background:

  • Coronavirus disease 2019 (COVID-19) can induce electrocardiographic (ECG) abnormalities, including ST-segment elevation.
  • These changes may arise from altered cardiac repolarization or delayed depolarization, potentially leading to misdiagnosis.
  • COVID-19 can mimic acute cardiac events, necessitating careful differential diagnosis.

Purpose of the Study:

  • To report a case of Brugada phenocopy triggered by COVID-19 in a patient with coronary artery disease.
  • To emphasize the importance of specific ECG metrics in diagnosing Brugada phenocopy.
  • To highlight appropriate management strategies for this condition.

Main Methods:

  • A 57-year-old male patient with hypertension and prior myocardial infarction presented with COVID-19 symptoms.
  • Electrocardiogram (ECG) revealed ST-segment elevation, and COVID-19 was confirmed via PCR.
  • Diagnosis of Brugada phenocopy was established using specific ECG parameters like the β-angle and r'-wave triangle base duration.

Main Results:

  • The patient received antiplatelet, antipyretic, and antiviral medications.
  • Following treatment, the patient's fever resolved, and repeat ECG showed normalization of ST-segment elevation.
  • The Brugada phenocopy pattern induced by COVID-19 was successfully managed.

Conclusions:

  • Fever-induced Brugada phenocopy should be considered in the differential diagnosis of ST-segment elevation in patients with coronary artery disease.
  • Precise ECG analysis, including β-angle and r'-wave morphology, is vital to prevent misdiagnosis of ST-elevation myocardial infarction.
  • Controlling triggering factors like fever with antipyretics and antivirals is crucial for preventing arrhythmias.
Abstract

Keywords:
Brugada patternCOVID-19electrocardiogramold myocardial infarction

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