Key result
A 30-year-old female developed a transient Brugada ECG pattern induced by hyperkalemia and metabolic acidosis following a complicated cesarean section, which normalized after hemodialysis.
Why the study?
Misidentifying Brugada phenocopy as true Brugada syndrome in critically ill patients with reversible triggers like hyperkalemia and acidosis can lead to inappropriate interventions.
Case Report (n=1)
Brugada phenocopy can be induced by hyperkalemia and metabolic acidosis in critically ill patients and resolves with correction of the underlying metabolic disturbances.
Brugada phenocopy (BrP) is an electrocardiographic (ECG) alteration that mimics Brugada syndrome (BrS) but lacks the associated genetic predisposition. It manifests as a transient pattern induced by reversible factors such as electrolyte imbalances, internal environment disturbances, and the use of certain drugs. In critically ill patients, hyperkalemia and acidosis are common triggers of this phenomenon, affecting ventricular repolarization and generating an ECG pattern identical to BrS. This report describes the case of a 30-year-old female patient who, following a complicated cesarean section with hemorrhagic shock, developed BrP induced by hyperkalemia and metabolic acidosis. The patient initially exhibited a type 1 Brugada ECG pattern, which evolved into a type 2 pattern and ultimately normalized after correction of the underlying disorders through hemodialysis. This case highlights the importance of an accurate differential diagnosis, as misidentifying BrP as true BrS could lead to inappropriate interventions, such as the implantation of defibrillators.
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García et al. (2025) conducted a case report in Brugada phenocopy (n=1). Hyperkalemia and metabolic acidosis was evaluated on ECG pattern normalization. A 30-year-old female developed a transient Brugada ECG pattern induced by hyperkalemia and metabolic acidosis following a complicated cesarean section, which normalized after hemodialysis.
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