Highlights the clinical importance of recognizing that the Brugada ECG pattern can be transient and unmasked by physiological stressors such as fever or sodium channel blocking medications.
Fever may unmask Brugada syndrome after VF arrest; leaves open whether fever-triggered ECGs or routine challenges should guide evaluation.
A 65-year-old man presented to the emergency department after he was resuscitated from cardiac arrest due to ventricular fibrillation. Coronary angiography demonstrated no evidence of coronary artery disease. Follow-up electrocardiograms (ECGs) were also unremarkable until the patient developed a fever, and a new ECG demonstrated a rapidly upsloping ST-segment followed by a downsloping, coved ST-segment in leads V1-V2. The diagnosis of Brugada syndrome was made after a procainamide challenge. The Brugada pattern on ECG can be transient and can manifest in the setting of fever or after taking medications with sodium channel blocking effects.
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Peng et al. (2023) studied this question.
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