Pyrexia induced Brugada syndrome in a patient undergoing emergency surgery

Abstract

SummaryA 44‐yr‐old male presented with intra‐abdominal sepsis and was listed for an emergency laparoscopic appendicectomy. During the course of his management it became apparent that he suffered from Brugada syndrome which manifest as a grossly abnormal ECG pattern that mimicked an ST elevation myocardial infarction (STEMI). Both STEMI and Brugada syndrome are potentially life threatening conditions that require very different treatment plans. The patient's abnormal ECG pattern resolved quickly after management of his sepsis and angiography was not required. A delay in surgery due to the misdiagnosis of a STEMI in septic patients with pyrexia‐induced Brugada syndrome may lead to a deterioration in their condition with potentially life threatening consequences. For this reason it is important that anaesthetists are aware of this relatively rare condition and have some understanding regarding its management.