Suspected hyponatremia-induced Brugada phenocopy

Figures & data

Figure 1 There is the characteristic ST-segment elevation ≥2 mm in ≥1 right precordial lead (V₁ to V₃), followed by an r'-wave and a straight ST-segment.

Notes: Additionally, the descending ST-segment crosses the isoelectric line and is followed by a negative and symmetric T-wave. At 40 ms of high takeoff, the decrease in amplitude of ST is ≤4 mm, the duration of QRS is longer than in a right bundle branch block and there is a mismatch between V₁ and V₆ (Figure 2)³. No high-pass filters were applied to attenuate low-frequency noise.^14,15

Figure 2 (A) Admission ECG upon presentation indicating a coved ST-segment elevation (black arrows) in V₁ and V₂, with elevated J points suggestive of a Brugada type 1 pattern. The patient’s serum sodium was 108 mg/dL (normal 135–145 mg/dL). (B) Day 5 ECG indicating resolution of the Brugada type 1 pattern (black arrows) with normalization of serum sodium. The patient’s serum sodium was 135 mg/dL (normal 135–145 mg/dL).

Abbreviation: ECG, electrocardiogram.

Bayés de LunaABrugadaJBaranchukACurrent electrocardiographic criteria for diagnosis of Brugada pattern: a consensus reportJ Electrocardiol201245543344222920782

 PubMed Web of Science ®Google Scholar

García-NieblaJLlontop-GarcíaPValle-RaceroJISerra-AutonellGBatchvarovVNde LunaABTechnical mistakes during the acquisition of the electrocardiogramAnn Noninvasive Electrocardiol200914438940319804517

 PubMed Web of Science ®Google Scholar

KnightBPPelosiFMichaudGFStrickbergerSAMoradyFClinical consequences of electrocardiographic artifact mimicking ventricular tachycardiaN Engl J Med1999341171270127410528037

 PubMed Web of Science ®Google Scholar