Brugada-Like Electrocardiographic Patterns Induced by Hyperkalemia

Dagmara Reingardienė,Jolita Vilčinskaitė,Diana Bilskienė

doi:10.3390/medicina49030024

Dagmara Reingardienė, Jolita Vilčinskaitė + Show 1 more

Open Access

https://doi.org/10.3390/medicina49030024

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Journal: Medicina	Publication Date: Apr 4, 2013
Citations: 4	License type: CC BY 4.0

Affiliation: Lithuanian University of Health Sciences

Abstract

Brugada syndrome was described in 1992 as a new clinical and electrocardiographic syndrome involving susceptibility to ventricular arrhythmias and sudden cardiac death in patients with no obvious structural heart disease. Brugada syndrome is characterized by a hereditary anomaly in the sodium ion channel (mutation of the SCN5A gene) identified by a wide QRS associated with the ST-segment elevation and the T‑wave inversion in the right precordial leads. The Brugada-like electrocardiographic pattern can be caused by sodium channel-blocking drugs and electrolyte disorders. Hyperkalemia may produce multiple ECG abnormalities, including the ST-segment elevation and pseudomyocardial infarction with a resolution of these abnormalities after the correction of hyperkalemia. This article describes 8 cases of pseudoanteroseptal myocardial infarction in acute renal insufficiency with hyperkalemia. The ST-segment elevation related to hyperkalemia is resolved by the reduced serum potassium level. Clinicians should recognize that hyperkalemia is one of the etiologies of the Brugada-like electrocardiographic pattern.

Highlights

Brugada syndrome (BS) is a specific clinical and electrocardiographic, often familial, pathology, characterized by typical electrocardiographic changes and frequent sudden cardiac death in the absence of a structural heart disease or a coronary vascular pathology [1, 2]
Three brothers Brugada, Spanish cardiologists, were first to describe the essence of this cardioelectrical pathology in 1992 [1, 3]
Case Reports We present the ECGs of 8 patients with Brugada ECG type 1 images caused by hyperkalemia

Summary

Introduction

Brugada syndrome (BS) is a specific clinical and electrocardiographic, often familial, pathology, characterized by typical electrocardiographic changes and frequent sudden cardiac death in the absence of a structural heart disease or a coronary vascular pathology [1, 2]. It is more difficult and more important to assess the signs of types 1, 2, and 3 Brugada-like ECG and partial right bundle branch block caused by electrolyte shifts, medications or their overdose, and intoxication. In these cases, it is not always easy to decide whether an electrolyte imbalance and drugs caused Brugada-like ECG images or showed previously unregistered BS ECG.

The ECGs of other patients with hyperkalemia

aVR

Findings

Conclusions