scholarly journals Fever Unmasked Brugada Syndrome in Pediatric Patient: A Case Report

2020 ◽  
Vol 4 (2) ◽  
pp. 244-246
Author(s):  
Orhay Mirzapolos ◽  
Perry Marshall ◽  
April Brill
Keyword(s):  
Emergency Medicine ◽  
Case Report ◽  
Brugada Syndrome ◽  
Ventricular Arrhythmias ◽  
Cardiac Monitoring ◽  
St Segment Elevation ◽  
Cardioverter Defibrillator ◽  
St Segment ◽  
Viral Illness ◽  
Automatic Implantable Cardioverter Defibrillator

Introduction: Brugada syndrome is an arrhythmogenic disorder that is a known cause of sudden cardiac death. It is characterized by a pattern of ST segment elevation in the precordial leads on an electrocardiogram (EKG) due to a sodium channelopathy. Case Report: This case report highlights the case of a five-year-old female who presented to the emergency department with a febrile viral illness and had an EKG consistent with Brugada syndrome. Discussion: Fever is known to accentuate or unmask EKG changes associated with Brugada due to temperature sensitivity of the sodium channels. Conclusion: Febrile patients with Brugada are at particular risk for fatal ventricular arrhythmias and fevers should be treated aggressively by the emergency medicine provider. Emergency medicine providers should also consider admitting febrile patients with Brugada syndrome who do not have an automatic implantable cardioverter-defibrillator for cardiac monitoring.

scholarly journals Neuroleptic-Induced Brugada Syndrome - A Case Report

2018 ◽  
Vol 5 ◽  
Author(s):  
Fouad Laboudi ◽  
Ghizlane Slimani ◽  
Mohamed Essaid Gourani ◽  
Abderrazzak Ouanass
Keyword(s):  
Case Report ◽  
High Risk ◽  
Sudden Death ◽  
Ventricular Arrhythmia ◽  
Brugada Syndrome ◽  
Genetic Disease ◽  
Autosomal Dominant ◽  
Dominant Inheritance ◽  
St Segment Elevation ◽  
St Segment

Brugada syndrome is a rare genetic disease, of autosomal dominant inheritance with low penetrance, manifested by ST segment elevation at right precordial V1, V2 and V3, and right branch block aspect. to the electrocardiogram. It exposes to a high risk of ventricular arrhythmia that can cause syncope and even sudden death, on a structurally healthy heart.We report here the case of a young patient of 25 years who has a syndrome of Brugada induced by a neuroleptic. To our knowledge, this is the first reported case of Brugada syndrome induced by a neuroleptic Morocco. Therapeutic management is based on Amiodarone and betablockers. Regular monitoring of the ECG should, however, be performed on patients taking psychotropic drugs and also on associations.

scholarly journals General Anesthetic Management for Patient with Brugada Syndrome: A Case Report

2020 ◽  
Vol 8 (6) ◽  
Author(s):  
Ji Won Bak ◽  
Se Jin Kim ◽  
Yeon Ji Roh ◽  
So Yeon Cho ◽  
Seongsik Kang
Keyword(s):  
Case Report ◽  
Ventricular Arrhythmia ◽  
General Anesthesia ◽  
Brugada Syndrome ◽  
Anesthetic Management ◽  
General Anesthetic ◽  
Bundle Branch Block ◽  
St Segment Elevation ◽  
St Segment ◽  
Block Pattern

Brugada syndrome is an arrhythmogenic cardiopathy characterized by electrocardiography (ECG) pattern of the presence of an atypical right bundle branch block pattern with ST segment elevation in the precordial leads (V1-V3). It is sometimes associated with sudden deaths caused by ventricular arrhythmia. Here, we are reporting a case of a 43-year-old male patient with Brugada syndrome who underwent a tonsillectomy under general anesthesia without any complications.

scholarly journals Brugada pattern: a comprehensive review on the demographic and clinical spectrum

2019 ◽  
Vol 12 (7) ◽  
pp. e229829 ◽  
Author(s):  
Hassan Abbas ◽  
Sohaib Roomi ◽  
Waqas Ullah ◽  
Asrar Ahmad ◽  
Ganesh Gajanan
Keyword(s):  
Brugada Syndrome ◽  
Ventricular Arrhythmias ◽  
Ecg Changes ◽  
Unique Case ◽  
St Segment Elevation ◽  
T Wave ◽  
Comprehensive Literature Review ◽  
St Segment ◽  
Syndrome Pattern ◽  
Brugada Pattern

A prominent coved or saddle-shaped ST-segment elevation followed by T wave changes in V1-V3 and in the absence of other identifiable cause is termed as Brugada pattern. This pattern in the presence of documented ventricular arrhythmias or its symptoms (syncope, seizure) or significant family for sudden cardiac death or abovementioned ECG changes is called Brugada syndrome. Here we present a comprehensive literature review on the precipitation factors of Brugada syndrome/pattern by various stimuli, its presentation, associations, management and outcomes. We are also presenting a unique case of Brugada pattern where the patient’s Brugada pattern was unmasked at an extreme old age by infection.

Rhabdomyoma of the interventricular septum presenting as a Brugada phenocopy

2011 ◽  
Vol 21 (5) ◽  
pp. 591-594 ◽  
Author(s):  
Timothy Nguyen ◽  
John Smythe ◽  
Adrian Baranchuk
Keyword(s):  
Sudden Death ◽  
Brugada Syndrome ◽  
Ventricular Arrhythmias ◽  
Interventricular Septum ◽  
St Segment Elevation ◽  
St Segment ◽  
The Right

AbstractBrugada syndrome is a channelopathy characterised electrocardiographically by distinctive coved ST-segment elevation in the right precordial leads and is associated with a predisposition for sudden death secondary to ventricular arrhythmias in otherwise healthy patients. Previously known as Brugada-like patterns, Brugada phenocopies include agents and conditions that mimic true Brugada syndrome, presenting with an acquired Brugada Type-1 ECG pattern. We describe the first reported case of a 17-month-old female with an asymptomatic rhabdomyoma of the interventricular septum that presented as a Brugada phenocopy.

Abstract 20180: Erroneous Diagnosis of Brugada Syndrome: Advanced Multi-Modality Coronary Evaluation to Establish an Ischemic Etiology for Recurrent Ventricular Arrhythmia

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Erin E Flatley ◽  
Andrew D Beaser ◽  
Husam H Balkhy ◽  
Sandeep Nathan ◽  
Joshua D Moss
Keyword(s):  
Chest Pain ◽  
Coronary Angiography ◽  
Brugada Syndrome ◽  
Ventricular Arrhythmias ◽  
Fractional Flow ◽  
Case Presentation ◽  
St Segment Elevation ◽  
Flow Reserve ◽  
St Segment ◽  
Erroneous Diagnosis

Introduction: Rapid diagnosis of ST-segment elevation (STE) myocardial infarction is mandatory for optimal treatment, but standard coronary angiography may occasionally result in misdiagnosis. Case presentation: A 54-year-old man was referred for second opinion on treatment of recurrent ventricular tachycardia (VT) and chest pain. Three years prior, he suffered a cardiac arrest requiring AED shock. Initial EKG showed 5-10 mm STE in leads V2-V6. Emergent coronary angiography at another facility reportedly showed non-obstructive disease, and STE resolved spontaneously. Procainamide challenge during a subsequent electrophysiology study elicited changes diagnosed as Brugada syndrome, and an ICD was implanted. Over the next several years, he had frequent episodes of VT, often associated with chest pain and terminated with anti-tachycardia pacing. Multiple antiarrhythmic drugs were ineffective, and VT ablation was recommended. Based on the history and original EKG, we proceeded with multi-modality coronary evaluation and provocative testing for coronary vasospasm. An indistinct proximal LAD lesion was further evaluated with fractional flow reserve (FFR) testing, showing a baseline FFR of 0.90 that decreased to 0.67 after administration of intracoronary adenosine. Optical coherence tomography (OCT) revealed 90% eccentric ostial LAD stenosis (see Figure). Given the location and severity of the lesion, he underwent successful robotic totally endoscopic beating heart LIMA-LAD bypass grafting. Post-operatively, both chest pain and episodes of VT resolved. Conclusions: The differential diagnosis of transient STE includes several non-coronary etiologies. However, in the setting of dramatic STE across the precordium and recurrent ventricular arrhythmias, a comprehensive, multi-modality coronary evaluation should be employed to identify lesions that may be otherwise equivocal via angiography or sites of significant vasospasm.

Clinical and Electrophysiologic Profile of Brugada Syndrome in Iranian Patients

2005 ◽  
Vol 13 (3) ◽  
pp. 241-246 ◽  
Author(s):  
Majid Haghjoo ◽  
Arash Arya ◽  
Zahra Emkanjoo ◽  
Mohammad Ali Sadr-Ameli
Keyword(s):  
Brugada Syndrome ◽  
Ventricular Arrhythmias ◽  
Symptomatic Patient ◽  
St Segment Elevation ◽  
Asymptomatic Patients ◽  
St Segment ◽  
Significant Difference ◽  
Pr Interval ◽  
Electrocardiographic Abnormalities

Clinical and electrophysiologic characteristics of 20 patients (15 males; mean age, 42 ± 9 years) with Brugada syndrome were studied. Electrocardiographic abnormalities (spontaneous in 6 and provoked in 14) were recognized in 5 symptomatic and 15 asymptomatic patients. Mean PR (188 ± 18 vs. 184 ± 24 ms) and QT (362 ± 34 vs. 382 ± 28 ms) intervals and ST-segment elevation (2.28 ± 0.42 vs. 2.70 ± 0.77 mm) were similar in both groups. The PR interval was slightly longer in males than females (191 ± 21 vs.168 ± 18 ms, p = 0.042), but ST-segment elevation (2.70 ± 0.78 vs. 2.24 ± 0.26 mm) was similar. The HV interval was longer in males than females (57 ± 4 vs. 50 ± 4 ms, p = 0.047). Ventricular arrhythmias were induced in 40% of asymptomatic patients. There was no significant difference in age, sex, PR interval, ST-segment elevation, or HV interval between inducible and non-inducible patients. A defibrillator was implanted in 8 patients. During 16 ± 2 months of follow-up, one symptomatic patient had appropriate device therapy. None of the asymptomatic and non-inducible patients experienced a cardiac event. Electrophysiologic data have no role in predicting inducibility in programmed stimulation.

Posterior wall myocardial infarction: A case report

2017 ◽  
Vol 70 (1-2) ◽  
pp. 44-47
Author(s):  
Milenko Cankovic ◽  
Snezana Bjelic ◽  
Vladimir Ivanovic ◽  
Anastazija Stojsic-Milosavljevic ◽  
Dalibor Somer ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Chest Pain ◽  
Myocardial Revascularization ◽  
Posterior Wall ◽  
Circumflex Artery ◽  
St Segment Elevation ◽  
Therapeutic Benefits ◽  
St Segment ◽  
Therapeutic Algorithms

Introduction. Acute myocardial infarction is a clinical manifestation of coronary disease which occurs when a blood vessel is narrowed or occluded in such a way that it leads to irreversible myocardial ischemia. ST segment depression in leads V1?V3 on the electrocardiogram points to the anterior wall ischemia, although it is actually ST elevation with posterior wall myocardial infarction. In the absence of clear ST segment elevation, it may be overlooked, leading to different therapeutic algorithms which could significantly affect the outcome. Case report. A 77 year-old female patient was admitted to the Coronary Care Unit due to prolonged chest pain followed by nausea and horizontal ST segment depression on the electrocardiogram in V1?V3 up to 3 mm. ST segment elevation myocardial infarction of the posterior wall was diagnosed, associated with the development of initial cardiogenic shock and ischemic mitral regurgitation. An emergency coronarography was performed as well as primary percutaneous coronary intervention with stent placement in the circumflex artery, the infarct-related artery. Due to a multi-vessel disease, surgical myocardial revascularization was indicated. Conclusion. Posterior wall transmural myocardial infarction is the most common misdiagnosis in the 12 lead electrocardiogram reading. Routine use of additional posterior (lateral) leads in all patients with chest pain has no diagnostic or therapeutic benefits, but it is indicated when posterior or lateral wall infarction is suspected. The use of posterior leads increases the number of diagnosed ST segment elevation myocardial infarctions contributing to better risk assessment, prognosis and survival due to reperfusion therapy.

scholarly journals What the Cardiologist Needs to Consider in the Management of Oncologic Patients with STEMI-Like Syndrome; A Case Report and Literature Review

2021 ◽  
Vol 14 (6) ◽  
pp. 563
Author(s):  
Aneta Aleksova ◽  
Giulia Gagno ◽  
Alessandro Pierri ◽  
Carla Todaro ◽  
Alessandra Lucia Fluca ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Side Effects ◽  
Single Agent ◽  
St Segment Elevation ◽  
Cardiac Catheterization Laboratory ◽  
Cardiac Side Effects ◽  
Coronary Syndrome ◽  
St Segment ◽  
Oncologic Patients

In pre-hospital care, an accurate and quick diagnosis of ST-segment elevation myocardial infarction (STEMI) is imperative to promptly kick-off the STEMI network with a direct transfer to the cardiac catheterization laboratory (cath lab) in order to reduce myocardial infarction size and mortality. Aa atherosclerotic plaque rupture is the main mechanism responsible for STEMI. However, in a small percentage of patients, emergency coronarography does not reveal any significant coronary stenosis. The fluoropyrimidine agents such as 5-Fluorouracil (5-FU) and capecitabine, widely used to treat gastrointestinal, breast, head and neck cancers, either as a single agent or in combination with other chemotherapies, can cause potentially lethal cardiac side effects. Here, we present the case of a patient with 5-FU cardiotoxicity resulting in an acute coronary syndrome (ACS) with recurrent episodes of chest pain and ST-segment elevation.. Our case report highlights the importance of widening the knowledge among cardiologists of the side effects of chemotherapeutic drugs, especially considering the rising number of cancer patients around the world and that fluoropyrimidines are the main treatment for many types of cancer, both in adjuvant and advanced settings.

Les facteurs cliniques qui influencent le pronostic post-infarctus à un an

1993 ◽  
Vol 18 (1) ◽  
pp. 63-79
Author(s):  
Sylvie Robichaud-Ekstrand
Keyword(s):  
Ventricular Arrhythmias ◽  
Prognostic Value ◽  
Left Ventricular ◽  
Cardiac Events ◽  
Mortality And Morbidity ◽  
St Segment Elevation ◽  
St Segment ◽  
Prognostic Stratification ◽  
History Of ◽  
Exercise Induced

Many clinical factors influence the 1-year prognosis in myocardial infarction (MI) patients. The most important clinical determinants are the left ventricular dysfunction, myocardial ischemia, and complex ventricular arrhythmias. Some authors have found an independent prognostic value of complex ventricular arrhythmias, while others consider that ventricular arrhythmias predict future cardiac events only if associated with low ejection fractions. Other factors that have 1-year prognostic value are the following: a previous MI, a history of angina at least 3 months preceding the infarct, postmyocardial angina, and the criteria that indicate to the practitioner whether MI patients are medically ineligible for stress testing. There still remain controversies in regard to the predictive value of certain variables such as the site, type, and extension of the MI, the presence of complex ventricular arrhythmias, exercise-induced hypotension, ST segment elevation, and the electrical provocation of dangerous arrhythmias. Key words: cardiac rehabilitation, postinfarct mortality and morbidity, cardiac events predictors, postinfarct prognostic stratification

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