Key result
Acute-on-chronic lithium intoxication induced ECG modifications including atrial fibrillation with wide QRS and ST-segment elevation, mimicking acute myocardial infarction and unmasking Brugada syndrome.
Why the study?
Lithium frequently causes ECG alterations that can have life-threatening consequences and lead to important changes in clinical management.
Case Report (n=1)
Clinicians should be aware that lithium intoxication can induce severe ECG alterations mimicking acute myocardial infarction and unmasking Brugada syndrome.
Answers are grounded in this paper and cite their sources.
Lithium toxicity may mimic STEMI and unmask Brugada on ECG; leaves open whether routine screening changes outcomes.
Lithium is frequently used in the treatment of bipolar disorders and is known to induce ECG alterations. This case study describes various patterns of lithium-induced ECG modifications in a patient with acute-on-chronic lithium intoxication. Clinicians should be familiar with this problem as it can have life-threatening consequences and lead to important changes in patient's management. Our patient was admitted for acute delirium with an ECG showing atrial fibrillation with wide QRS and ST-segment elevation. These modifications were first mistaken for an acute myocardial infarction and a diagnosis of Brugada syndrome was finally reached. Treatment after the acute phase implied changes in the therapeutic modality and required frequent monitoring.
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Diserens et al. (2021) conducted a case report in Acute-on-chronic lithium intoxication (n=1). Lithium intoxication was evaluated on ECG modifications (atrial fibrillation with wide QRS and ST-segment elevation). Acute-on-chronic lithium intoxication induced ECG modifications including atrial fibrillation with wide QRS and ST-segment elevation, mimicking acute myocardial infarction and unmasking Brugada syndrome.
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