Why the study?
Prompt recognition of Brugada syndrome is critical because it can rapidly evolve into life-threatening arrhythmias and sudden cardiac death, often unmasked by stressors such as fever and electrolyte imbalance.
Fever secondary to Influenza A infection can unmask the Type 1 Brugada ECG pattern, necessitating prompt recognition to prevent sudden cardiac death.
Case report of Brugada unmasked by stressors; leaves open generalizability and optimal management strategies.
Brugada syndrome is an inherited disorder characterized by a channelopathy of cardiac sodium, potassium, and calcium channel. The pathophysiology of this disorder is not completely elucidated yet, however, most of the reported cases are caused by a pathogenic alteration in the SCN5A gene, leading to the malfunction of cardiac sodium channels. Several stressors are well known to unmask this pathology including fever and electrolytes imbalance. Three ECG patterns are frequently described in the literature, type 1, type 2, and type 3. However, only the type 1 pattern is considered diagnostic of Brugada syndrome in the appropriate clinical context. Therapeutic strategies can range from conservative medical management with antiarrhythmic medications to Automatic Implantable Cardioverter Defibrillator (AICD) placement. Prompt recognition is of utmost importance since this pathology can rapidly evolve into life-threatening arrhythmias and sudden cardiac death. Here we present a case of a 22-year-old male who presented after a syncopal episode and was found to have Brugada syndrome in the setting of Influenza A infection.
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Elkattawy et al. (2023) studied this question.
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