Transient Brugada-like ECG pattern incited by uncontrolled hypertension - a rare case report

Abstract

Background: Brugada syndrome (BrS) is a rare form of channelopathy caused by mutation of SCN5A gene that encodes for sodium channel and is associated with increased risk of ventricular arrhythmia and sudden cardiac death. BrS has a characteristic electrocardiographic (ECG) pattern. Various stressors can induce Brugada-like pattern on ECG in the absence of BrS known as Brugada phenotype. Case Presentation: We report a case of a 28-year-old African-American male patient who presented to the emergency department with a chief complaint of atypical chest pain. He was noted to have an elevated blood pressure and a type 1 Brugada pattern on his 12-lead ECG. His ECG changed from type 1 to type 3 Brugada pattern upon controlling blood pressure, which indicated the presence of a Brugada phenocopy. Conclusion: It is important to recognize the underlying stressors that can lead to Brugada-like patterns on the ECG since these stressors are treatable without any sequel.