Department of Cardiology and Vascular Medicine, Medical Faculty, Hasanuddin University, Makassar, Indonesia.
Dr. Wahidin Sudirohusodo National General Hospital, Makassar, Indonesia.
Malar J. 2024 Sep 17;23(1):283. doi: 10.1186/s12936-024-05099-3.
Cardiovascular events following anti-malarial treatment are reported infrequently; only a few studies have reported adverse outcomes. This case presentation emphasizes cardiological assessment of Brugada syndrome, presenting as life-threatening arrhythmia during anti-malarial treatment. Without screening and untreated, this disease may lead to sudden cardiac death.
This is a case of 23-year-old male who initially presented with palpitations followed by syncope and shortness of breath with a history of malaria. He had switched treatment from quinine to dihydroartemisinin-piperaquine (DHP). Further investigations revealed the ST elevation electrocardiogram pattern typical of Brugada syndrome, confirmed with flecainide challenge test. Subsequently, anti-malarial treatment was stopped and an Implantable Cardioverter Defibrillator (ICD) was inserted.
Another possible cause of arrhythmic events happened following anti-malarial consumption. This case highlights the possibility of proarrhytmogenic mechanism of malaria infection and anti-malarial drug resulting in typical manifestations of Brugada syndrome.
抗疟治疗后发生心血管事件的报道很少；只有少数研究报告了不良后果。本病例介绍强调了疟疾治疗期间出现危及生命的心律失常时对 Brugada 综合征的心脏评估。如果不进行筛查和治疗，这种疾病可能导致心源性猝死。
这是一名 23 岁男性，最初表现为心悸，随后出现晕厥和呼吸急促，并患有疟疾。他已将奎宁换为双氢青蒿素-哌喹（DHP）进行治疗。进一步的检查显示心电图呈 Brugada 综合征典型的 ST 段抬高模式，通过氟卡尼激发试验得到证实。随后，停止了抗疟治疗，并植入了植入式心脏复律除颤器（ICD）。
抗疟治疗后发生心律失常的另一个可能原因。本病例强调了疟疾感染和抗疟药物的致心律失常机制的可能性，导致 Brugada 综合征的典型表现。
