A very few case reports have indicated that hyperkalemia can induce a Brugada pattern in the electrocardiogram (EKG). On the other hand, very rare case reports have indicated that cocaine has precipitated life-threatening arrhythmias associated with development of Brugada syndrome. We present a 26-year old patient with hyperkalemia secondary to muscle damage and renal insufficiency after a reported large intake of cocaine. The electrocardiogram showed a Brugada pattern. These EKG changes disappeared directly after normalization of serum potassium. We concluded that cocaine and the hyperkalemia were probably the culprit causes of the Brugada-pattern EKG. Unfortunately, the provided data in this case appear to be incomplete; the patient was found unresponsive at home, and we do not exactly whether or not he developed a cardiac arrest secondary to a malignant arrhythmia before the arrival of the Emergency medical services. This case highlights the importance of recognizing cocaine and hyperkalemia as potentialtriggers of the acquired Brugada-like electrocardiographic pattern.
A 63 year old white man with hypertension presents complaining of episodes of light headedness and generalized weakness, in the last year, more frequent in the last few weeks. He has noticed an overall decline in heart rate (HR) while exercising on treadmill. Atenolol dose was decreased a month ago with no improvement. Physical exam revealed a right sided goiter, otherwise unremarkable. Labs, EKG, Stress test and Echocardiogram were within normal limits. No pauses on the monitor. Carotid massage revealed a significant decrease in HR from 78 to 45 with lightheadedness when done on the right side. Atenolol was discontinued and he was discharged with event monitor. He returned to the hospital few days later with recurrent symptoms. Event monitor showed a sudden decrease in HR from 120 to 70 during exertion. Further questioning showed that all episodes were precipitated by turning his head to the right side. We suspected that the neck mass is compressing the carotid sinus and causing bradycardia. CT neck showed a large goiter compressing on adjacent structures. Thyroidectomy was done and patient was seen six weeks later with no more spells.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.