Phenocopia of brugada syndrome: an under-diagnosed entity?

Abstract

Abstract Introduction Brugada phenocopy (BSF) presents as an electrocardiographic pattern similar to Brugada syndrome (BS), however, they differ in etiology, being that it will be found in association with any identifiable condition and when said condition is resolved, the electrocardiogram does not present the characteristic pattern. Since the recognition of the FSB, 122 cases have been registered worldwide, there are reports of ischemic heart disease, secondary to fluid and electrolyte imbalance, pulmonary thromboembolism, electrocution and inappropriate electrocardiographic filters, considering multiple nosological entities with a common electrocardiographic manifestation that has a different prognosis to BS Therefore, the recognition of the FSB requires a diagnostic study in order to establish specific treatment in a timely manner. Purpose To present 3 clinical cases of this little-known entity that did not present risk factors or family history in a cardiology reference center. Methods A search was carried out, finding three cases from 2015–2021, the first case a 22-year-old patient with a history of Duchenne familial dystrophy and hydroelectrolytic imbalance at admission with Brugada type 1 pattern (A) corrected after treatment (B), A 26-year-old female with pulmonary thromboembolism with a Brugada Type I pattern corrected after treatment, a 55-year-old female in the immediate postoperative period of revascularization surgery who, after 48 hours, corrected a Brugada type I pattern (C). Conclusion The differential diagnosis is based mainly on the fact that FBS is due to: secondary etiology, which, once resolved, will normalize the electrocardiographic pattern, negative challenge test with sodium channel blockers and low pretest for congenital BS, contrary to patients with BS that do not present these characteristics, so a differential diagnosis must be made in patients with a BS pattern. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Instituto Nacional de Cardiologia Ignacio Chavez