Liroff Joshua, Gilbert Karyn, Kim Brian S
Emergency Department, Henry Ford Allegiance Health, Jackson, MI.
Spartan Med Res J. 2016 Oct 24;1(1):5072. doi: 10.51894/001c.5072.
Brugada is a malignant cardiac dysrhythmia characterized by ST elevations in precordial leads V1 to V3. It is an autosomal dominant disease, and patients are usually asymptomatic. Often the initial presenting symptom of this syndrome is syncope or sudden cardiac death (SCD). In patients with this syndrome, the only definitive treatment is the implantation of a cardioverter-defibrillator device (ICD). Previously it has been reported that Brugada type EKG patterns have been observed in patients who have used sodium channel blocking medications/drugs and in patients who are febrile. In this case, a 58 year-old male presented to our emergency department with a fever of five days duration and a non-productive cough. The patient was initially diagnosed with bilateral pneumonia, however during the initial workup his EKG demonstrated a Brugada type EKG pattern. The patient did not have any history of cardiac disease, nor was there any history of syncope or SCD in his family. The patient was eventually discharged from the hospital four days after his initial presentation and instructed to follow up with cardiology. Brugada type EKG patterns are known to occur in patients in febrile states and in those patients using certain types of medications. In those patients who present under the above mentioned conditions who are otherwise asymptomatic, the literature does not support the implantation of an ICD.
Brugada综合征是一种恶性心律失常，其特征为胸前导联V1至V3出现ST段抬高。它是一种常染色体显性疾病，患者通常无症状。该综合征最初的常见症状往往是晕厥或心源性猝死（SCD）。对于患有该综合征的患者，唯一确切的治疗方法是植入心脏复律除颤器（ICD）。此前有报道称，在使用钠通道阻滞剂药物的患者以及发热患者中观察到了Brugada型心电图模式。在本病例中，一名58岁男性因持续五天的发热和干咳前来我院急诊科就诊。患者最初被诊断为双侧肺炎，然而在初步检查期间，他的心电图显示出Brugada型心电图模式。该患者没有任何心脏病史，其家族中也没有晕厥或心源性猝死的病史。患者在首次就诊四天后最终出院，并被要求到心脏病科进行随访。已知在发热状态的患者以及使用某些类型药物的患者中会出现Brugada型心电图模式。对于在上述情况下就诊且无其他症状的患者，文献并不支持植入ICD。
