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. 2014 Jul 22;10(3):81-84.
doi: 10.1016/j.jccase.2014.03.012. eCollection 2014 Sep.

Intermittent Brugada syndrome in an anorexic adolescent girl

Martine K F Docx  1 , Bart Loeys  2 , Annik Simons  3 , Marc Gewillig  4 , Dorien Proost  2 , Lut Van Laer  2 , Luc Mertens  5
Affiliations

Intermittent Brugada syndrome in an anorexic adolescent girl

Martine K F Docx et al. J Cardiol Cases. .

Abstract

We report an anorexic adolescent girl with an intermittent Brugada syndrome. A 14-year-old anorexic girl with a body mass index (BMI) of 13.15 kg/m2 was admitted in the acute state of the disease with an ST elevation in V1 and V2, suggestive of Brugada syndrome. After 1 month of re-feeding, a control electrograph (ECG) was normal, but after an 8-month follow-up control with a nearly normal BMI, the ECG was again suggestive of Brugada syndrome. A genetic analysis of the gene SNC5A established a genetic change (p Leu 1582 pro), which provides the final explanation for the Brugada syndrome. Every rhythm problem in the acute state or during the re-feeding procedure deserves a strict follow-up to distinguish iatrogenic from heritable rhythm problems. <Learning objective: (i) We report the first case of a patient with anorexia nervosa with an intermittent Brugada syndrome. (ii) Moderate hypothermia can decrease the depolarization of pacemaker cells and cause ST-segment changes. (iii) Every rhythm problem in the acute state or during the re-feeding procedure deserves a strict follow-up to distinguish iatrogenic from heritable rhythm problems. (iv) A genetic analysis can make the distinction and is necessary to give advice for the future lifestyle of the patient.>.

Keywords: Anorexia nervosa; Brugada syndrome; Hypothermia; Iatrogenic; Weight loss.

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Figures

Fig. 1
Fig. 1
A 12-lead electrocardiogram – ST elevation in V1, V2 and less in V3. Rhythm: 49 bpm, axis 11°, PR interval: 144 ms, QRS: 114 ms, QT: 422 ms, and QTc 384 ms. Type I electrocardiogram.
Fig. 2
Fig. 2
Magnetic resonance imaging of the heart: moderate pericardial effusion.
Fig. 3
Fig. 3
Magnetic resonance imaging of the brain: “cerebral atrophy” in the frontotemporal and cerebellar region.
Fig. 4
Fig. 4
After 1 month of re-feeding: normalization of the electrocardiogram.
Fig. 5
Fig. 5
After 8 months of re-feeding: body mass index: 18.5 kg/m2 again Brugada syndrome typical type I electrocardiogram (ECG). Three different 12-lead ECGs are shown.
See this image and copyright information in PMC

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