Abstract
Brugada Syndrome (BrS) is a rare autosomal disease caused by a genetic mutation affecting the ion channels of the cardiac conduction system. The administration of some routinely used anesthetic agents have shown to trigger spontaneous ventricular arrhythmias on BrS patients leading to sudden cardiac arrest. This is a case report on a 20year-old male patient with a history of cocaine abuse presenting to the emergency room (ER) with palpitations, chest discomfort, and syncope. Electrocardiogram (ECG) changes led to the diagnosis of BrS. The patient underwent an automatic implantable cardioverterdefibrillator (AICD) under general anesthesia without any complications, however routine anesthetic agents may induce lethal arrhythmias in BrS. This case report focuses on increasing the safety awareness for anesthesia care of patients with BrS.
Highlights
Brugada Syndrome (BrS) is a rare autosomal disease caused by a genetic mutation affecting the ion channels of the cardiac conduction system
Induced Ventricular fibrillation (VF) intra-operatively converted to sinus rhythm, if the VF required immediate emergency management, the use of a class I antiarrhythmic agent such as lidocaine could worsen this patient’s condition due to its effect on the sodium ion channels affecting cardiac conduction [2]
The administration of propofol and neostigmine has shown to induce arrhythmias on some BrS patients according to the evidence from the literature [2,3]
Summary
Brugada Syndrome (BrS) is a rare autosomal disease caused by a genetic mutation affecting the ion channels of the cardiac conduction system. The administration of some routinely used anesthetic agents have shown to trigger spontaneous ventricular arrhythmias on BrS patients leading to sudden cardiac arrest. This is a case report on a 20year-old male patient with a history of cocaine abuse presenting to the emergency room (ER) with palpitations, chest discomfort, and syncope.
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