Brugada Pattern Phenocopy Induced by Diabetic Ketoacidosis

Abstract

Brugada syndrome is a congenital cardiac channelopathy characterized by ST-segment elevation (≥2 mm) and subsequent inverted T wave in a minimum of two right precordial leads (Brugada type 1 ECG [electrocardiogram] pattern) on ECG. Brugada syndrome is estimated to be responsible for 4%-12% of all sudden cardiac deaths and up to 20% in patients with structurally normal hearts. Development of a temporary Brugada pattern, known as Brugada phenocopy, has been observed in individuals presenting with reversible underlying conditions such as hyperkalemia, hyponatremia, acidosis, ischemia, and pulmonary embolism, among others. Herein we present a case of Brugada phenocopy seen in a patient in diabetic ketoacidosis, which resolved after the electrolyte abnormalities were corrected.

Brugada Phenocopy Induced by Hypovolemic Hyponatremia

“…Landa et al reported a demonstrative type 1 Brugada pattern presenting with diabetic ketoacidosis, hyponatremia, and hyperkalemia in a follow-up patient diagnosed with type 1 diabetes mellitus. In their presentation, the authors demonstrated that the elimination of metabolic and electrolyte disturbances produced a dramatic improvement in ECG findings [ 16 ]. Multiple electrolyte disturbances are not always necessary for BrP.…”