Wu Lung-Sheng, Wu Chia-Tung, Hsu Lung-An, Luqman Nazar, Kuo Chi-Tai
Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 199, Tunhwa N. Road, Taipei, Taiwan, Republic of, China.
Europace. 2007 Mar;9(3):172-4. doi: 10.1093/europace/eum002.
There are several causes for ST segment abnormalities in leads V1 to V3. Hypercalcaemia and Brugada syndrome are among them. Both are known to produce ventricular arrhythmia, albeit only rare cases have been reported with documented evidence of ventricular arrhythmias in association with a hypercalcaemic crisis but none when hypercalcaemic coexists with Brugada syndrome. We describe a patient with primary hyperparathyroidism who presented with ventricular fibrillation, and the ECG showed changes similar to Brugada syndrome. The provocation test with flecainide was conducted twice. This was positive, both before and after parathyroidectomy when serum calcium and parathormone levels had normalized. The patient was treated for hypercalcaemia and underwent parathyroidectomy. This is the first report of oral flecainide test unmasking the diagnostic coved Brugada ECG pattern in a patient with primary hyperparathyroidism and raising attention to hypercalcaemia as a potential trigger for life-threatening arrhythmia in Brugada syndrome.
V1至V3导联ST段异常有多种原因。高钙血症和Brugada综合征都在其中。已知两者都会引发室性心律失常，尽管仅有罕见病例报告记录了与高钙血症危象相关的室性心律失常，但高钙血症与Brugada综合征并存时则无此类报告。我们描述了一名原发性甲状旁腺功能亢进患者，其出现室颤，心电图显示出与Brugada综合征相似的变化。进行了两次氟卡尼激发试验。在甲状旁腺切除术前和术后血清钙和甲状旁腺激素水平恢复正常时，该试验均呈阳性。该患者接受了高钙血症治疗并接受了甲状旁腺切除术。这是关于口服氟卡尼试验揭示原发性甲状旁腺功能亢进患者诊断性隐匿性Brugada心电图模式并提醒注意高钙血症作为Brugada综合征中危及生命心律失常潜在触发因素的首例报告。
