Cocaine And Hyperkalemia Unmasked The Electrocardiogram (EKG) Pattern Of Brugada Syndrome

Abstract

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.