It took a Redbull to unmask Brugada syndrome

Abstract

The SCN5a gene encodes the sodium channels present on the myocardium. A mutation of the SCN5a gene results in a dysfunctional sodium channel that has been linked to the Brugada syndrome. The Brugada syndrome frequently presents in males with a syncopal episode secondary to arrhythmias. Substances such as medications, alcohol, and more recently noted caffeine and taurine can have a deleterious effect on the sodium channels, increasing the risk of arrhythmias. Here we present a patient who was diagnosed with Brugada syndrome after experiencing a syncopal episode due to ventricular arrhythmia following ingestion of Red Bull energy Drink. The Brugada syndrome is a result of a mutation the SCN5a gene that encodes for sodium channels in the myocyte [1–4]. Dysfunction of the sodium channels can result in arrhythmias, which could potentially be fatal. Certain drugs affect the ability of the sodium channels to function appropriately, increasing the risk of arrhythmias within this patient population [5–7]. These drugs include antiarrhythmics, calcium channel blockers, beta blockers, and antipsychotics [2,8–12]. Additionally, it has been suggested that common beverage ingredients such as caffeine, and to a lesser degree taurine, may also negatively affect the function of sodium channels [13–15]. These ingredients are present in energy drinks, which have gained in popularity in recent years. In this report, we present a patient with Brugada syndrome who developed arrhythmias secondary to ingestion of an energy drink combined with alcohol. We present a case of a 24 year old male with no previous medical history who was celebrating a play opening at a local bar. The patient was consuming a Red Bull energy drink containing 80 mg caffeine