Fever-Induced Brugada-Pattern Electrocardiogram

Abstract

Background: Brugada syndrome is an increasingly recognized syndrome characterized by a particular electrocardiography (ECG) pattern and clinical criteria and has a high incidence of sudden death in patients with structurally normal hearts. The Brugada ECG pattern can be unmasked by drugs, ischemia, and fever.

Case report: We present the case of a 47-year-old man who presented to the emergency department with flu-like symptoms and syncope. On arrival, he was febrile and his ECG showed a Brugada pattern. Although this pattern resolved once his fever resolved, the cardiologists were concerned that his syncopal episode might have been due to ventricular tachycardia/fibrillation, and the patient was admitted for implantable cardiac defibrillator placement. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Fever and other stressors can unmask a Brugada pattern on ECG, and if patients have concerning clinical criteria, they should receive emergent cardiology follow-up.

Keywords: Brugada; cardiology; electrocardiography; syncope.