Korean J Med.  2011 Jun;80(Suppl 2):S166-S171.

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

• Lee JB
• Lee MY
• Lee SJ
• Hwang HJ
• Park HK
• Choi YS
• Park CS

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.

Keyword

Acute coronary syndrome; Brugada syndrome; Idiopathic Brugada ECG pattern; Fever; Pneumonia

MeSH Terms

Acute Coronary Syndrome
Adult
Brugada Syndrome
Chest Pain
Constriction, Pathologic
Coronary Angiography
Coronary Vessels
Electrocardiography
Emergencies
Fever
Flecainide
Humans
Pneumonia
Thrombosis
Flecainide