Brugada Syndrome Unmasked by Fever: A Rare Cause of ST-Segment Elevation

Brugada syndrome is a rare cardiac condition associated with an increased risk of ventricular arrhythmias and sudden cardiac death. Fever is a recognized trigger that can unmask Brugada patterns on electrocardiography (ECG), yet fever-induced Brugada syndrome remains uncommon and is often underdiagnosed.

We report the case of a 72-year-old man who presented to the emergency department with intermittent fever and lower back pain. Eight hours after admission, during a febrile episode with a body temperature of 39°C, the patient developed chest tightness. ECG revealed ST-segment elevation and an rSR' pattern in leads V1 and V2, consistent with a Type 1 Brugada pattern. Emergent coronary angiography showed normal coronary arteries. With the resolution of fever, the patient's symptoms subsided, and subsequent ECGs returned to normal sinus rhythm. He remained asymptomatic throughout his hospital course and follow-up.

This case highlights the diagnostic challenge of fever-induced Brugada syndrome, which can mimic acute coronary syndromes. Prompt recognition and appropriate evaluation are essential to prevent misdiagnosis and optimize patient outcomes. Further studies are needed to clarify the prevalence and clinical significance of fever-induced Brugada patterns in diverse populations.