Key result
A febrile illness disclosed a typical ECG pattern of Brugada syndrome in a patient with complete right-bundle branch block, which was reproduced by intravenous pilsicainide.
Case Report (n=1)
No
Physicians should carefully evaluate ECG changes during a febrile state, as fever can unmask Brugada syndrome even in patients with a typical complete right bundle branch block pattern.
May support ECG vigilance during fever even with complete RBBB; single case leaves open broader diagnostic implications.
The characteristic of right-bundle branch block (RBBB) pattern in Brugada syndrome (BS) is an atypical pattern without a wide S wave in left leads. We present a case of a patient with BS who had a typical ECG pattern of complete RBBB (CRBBB) with a wide S wave in the left leads which was disclosed by a febrile illness. Our observations suggest that physicians should be careful to evaluate ECG change in response to a febrile state, even if the ECG shows a typical CRBBB pattern with deep and wide S waves in the left leads.
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Shinohara et al. (2008) conducted a case report in Brugada Syndrome (n=1). Febrile illness vs. Afebrile state was evaluated on ECG changes (coved-type ST segment elevation). A febrile illness disclosed a typical ECG pattern of Brugada syndrome in a patient with complete right-bundle branch block, which was reproduced by intravenous pilsicainide.
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