Hermida Jean-Sylvain, Six Isabelle, Jarry Geneviève
Cardiology Department, Amiens-Picardie University Hospital, Service de Cardiologie A, Groupe Hospitalier Sud, Avenue René Laënnec, 80054 Amiens Cedex 1, France.
Europace. 2007 Jan;9(1):66-8. doi: 10.1093/europace/eul140.
Brugada syndrome (BS) is associated with sudden cardiac death in patients with a structurally normal heart. The ECG pattern of BS has also been described in patients with myocardial abnormalities. Cardiac hypersensitivity and myopericarditis have been reported during long-term treatment with mesalazine. We report the case of a man, treated with mesalazine for Crohn's disease who developed drug-induced pericarditis. The ECG showed a coved ST-segment elevation in the right precordial leads V1-V3, a pattern mimicking BS. The ECG normalized in a few days after mesalazine withdrawal and the follow-up was uneventful. The ECG remained normal. Two ajmaline tests were both negative and ruled out the diagnosis of BS. This observation illustrates that a coved ST-segment elevation in the right precordial leads should not be, systematically, regarded as a marker of a specific syndrome, but may also reflect a common electrical manifestation of abnormalities in the right ventricle or pericardium.
布加综合征（BS）与心脏结构正常的患者发生心源性猝死有关。在心肌异常的患者中也描述过BS的心电图模式。在美沙拉嗪长期治疗期间曾报告过心脏超敏反应和心肌心包炎。我们报告一例因克罗恩病接受美沙拉嗪治疗的男性患者，该患者发生了药物性心包炎。心电图显示右胸前导联V1-V3出现穹窿型ST段抬高，这种模式酷似BS。停用美沙拉嗪几天后心电图恢复正常，随访期间无异常情况。心电图保持正常。两次阿义马林试验均为阴性，排除了BS的诊断。该观察结果表明，右胸前导联穹窿型ST段抬高不应一概被视为特定综合征的标志，也可能反映右心室或心包异常的常见电表现。
