Aryal Egesh, Mainali Agya, Aryal Saurav
Nepalese Army Institute of Health Sciences-College of Medicine, Kathmandu.
National Academy of Medical Sciences, Bir Hospital, Kathmandu.
Ann Med Surg (Lond). 2024 Jun 19;86(8):4891-4894. doi: 10.1097/MS9.0000000000002286. eCollection 2024 Aug.
Brugada syndrome (BrS) is a rare genetic disorder with specific electrocardiographic (ECG) patterns carrying an increased risk of sudden cardiac death.
The authors present a 36-year-old gentleman who had a travel history to the Central African Republic and came to the hospital with a fever and chest pain. The lab investigation revealed Falciparum Malaria infection and the ECG pattern revealed the type 1 Brugada pattern, which was normalized with anti-malarial medication and symptomatic treatment of fever.
BrS is a disorder with high prevalence in males and people of the Asian continent. Patients can present with symptoms like syncope, seizure, and nocturnal agonal respiration or may be asymptomatic. The ECG pattern of BrS could be seen in the febrile phase and normalized when non-febrile, like in our patient. Prompt treatment of fever and follow-up with cardiologists would be an effective treatment of asymptomatic patients, whereas ICD is a management of choice for symptomatic patients.
For a patient with chest pain, fever, and an ECG pattern of ST elevation, a clinician should think BrS one of the differential diagnoses.
Brugada综合征（BrS）是一种罕见的遗传性疾病，具有特定的心电图（ECG）模式，会增加心脏性猝死的风险。
作者介绍了一名36岁男性，他有前往中非共和国的旅行史，因发热和胸痛入院。实验室检查显示感染了恶性疟原虫，心电图模式显示为1型Brugada模式，经抗疟疾药物治疗和发热症状治疗后恢复正常。
BrS在男性和亚洲大陆人群中患病率较高。患者可能出现晕厥、癫痫发作和夜间濒死呼吸等症状，也可能无症状。BrS的心电图模式可在发热期出现，退热后恢复正常，就像我们的患者一样。及时治疗发热并由心脏病专家进行随访是无症状患者的有效治疗方法，而植入式心律转复除颤器（ICD）是有症状患者的首选治疗手段。
对于有胸痛、发热且心电图显示ST段抬高的患者，临床医生应将BrS列为鉴别诊断之一。
