Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2013;66:309 - Vol. 66 Num.04 DOI: 10.1016/j.rec.2011.04.021

Hyperkalemia Mimicking a Pattern of Brugada Syndrome

Lluis Recasens a,, Oona Meroño a, Nuria Ribas a

a Servicio de Cardiología, Hospital del Mar, Barcelona, Spain

Refers to

Brugada Phenocopy Emerging as a New Concept
Daniel D. Anselm, Adrian Baranchuk
Rev Esp Cardiol. 2013;66:755
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Article

A 70-year-old patient with a history of hypertension and dyslipidemia was receiving treatment with enalapril, simvastatin, and hydrochlorothiazide. He was referred to our hospital for presyncope and suspected acute myocardial infarction in an anterior location. The first electrocardiogram (Figure 1A) showed a saddlebag-type ST segment elevation in V1 to V3. Echocardiography excluded a segmental wall motion abnormality. Despite the patient's advanced age and the absence of previous episodes of syncope or a family history of sudden death, the presumptive diagnosis was Brugada syndrome. The initial analyses showed creatinine 4.88mg/dL, Na 127mEq/L, K 7.53mEq/L, pH 7.22, and troponin T <0.01ng/mL.

Figure 1.

The patient was treated for hyperpotassemia and was hospitalized to investigate renal failure. Once the potassium concentration had normalized, a new electrocardiographic study was carried out (Figure 1B), in which the Brugada pattern had disappeared. Nonetheless, a flecainide test was performed, with negative results. Various situations have been described in which an electrocardiographic pattern of Brugada syndrome is manifested, such as drug-related conditions, heart diseases, acute myocardial infarction with ST segment elevation, muscular dystrophy, and hypothermia. Although hyperpotassemia can display diverse manifestations on electrocardiography, a presentation mimicking a Brugada pattern is very unusual.

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Corresponding author: 91637@parcdesalutmar.cat

1885-5857/© 2013 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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