Unmasking of the Idiopathic Brugada Electrocardiogram Pattern in a Febrile Patient with Pneumonia

Korean J Med > Volume 80(2); 2011 > Article

Original Article

The Korean Journal of Medicine 2011;80(2):166-171.

Unmasking of the Idiopathic Brugada Electrocardiogram Pattern in a Febrile Patient with Pneumonia

Jae Beom Lee, Man Young Lee, Sung-Jin Lee, Hui-Jeong Hwang, Hyun Keun Park, Yun-Seok Choi, Chul-Soo Park

발열을 동반한 폐렴환자에서 발견된 특발성 Brugada 심전도 패턴 1예

이재범, 이만영, 이성진, 황희정, 박현근, 최윤석, 박철수

Abstract

We present the case of a 44-year-old man who presented with continuous chest pain and fever with pneumonia. Additionally, idiopathic Brugada ECG patterns were observed. The patient’s initial electrocardiogram showed ST-segment elevation at the right precordial and lateral leads. An emergency coronary angiography showed that there was no significant stenosis or thrombus in the coronary arteries. ECG findings showed Brugada ECG patterns, which were exaggerated by high fever. The diagnosis was confirmed with a flecainide provocation test that allowed us to document ECG changes consistent with type 1 Brugada ECG patterns. This case report reveals how dynamic ST-segment elevations may look similar in cases of acute coronary syndrome and Brugada syndrome. Additionally, we showed that Brugada ECG patterns can be exaggerated by fever.

Key Words: Acute coronary syndrome; Brugada syndrome; Idiopathic Brugada ECG pattern; Fever; Pneumonia