NDLI: Heat stroke, an unusual trigger of Brugada electrocardiogram.

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Heat stroke, an unusual trigger of Brugada electrocardiogram.

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Heat stroke, an unusual trigger of Brugada electrocardiogram.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Lacunza, Javier San Román, Irene Moreno, Sara García-Molina, Esperanza Gimeno, Juan Valdés, Mariano
Description	Country affiliation: Spain Author Affiliation: Lacunza J ( Department of Cardiology, University Hospital Virgen de la Arrixaca, 30120 Murcia, Spain. javierlacunzaruiz@gmail.com)
Abstract	A young male individual with diagnosis of heat stroke was admitted unconscious to hospital. Electrocardiogram (ECG) at admission demonstrated typical right bundle branch block and ST-segment elevation in V1 and V2 (coved morphology) diagnostic of Brugada syndrome. Maximal creatine kinase was 10,131 (IU/L); creatine kinase-MB, 15 (IU/L); troponin T, 0.039 ng/mL; and creatinine 1.6, mg/dL. Patient recovered from coma on day 6. Electrocardiogram normalized within the first 24 hours; no arrhythmias were documented. Echocardiogram before discharge was normal. Brugada ECG pattern can express intermittently, and challenge tests with a sodium channel blocker are often required for diagnosis. Ventricular arrhythmias and sudden death occur typically at night or during enhanced vagal activity. Fever has been related to polymorphic ventricular tachycardia particularly in children; nevertheless, prevalence is higher within males in their fourth to fifth decade. Mutations in SCN5A gene encoding a sodium channel can be found in up to 30% of cases. This sodium channel is sensitive to temperature changes. Sequencing of the gene failed to find any abnormality in our patient. A possible role of heat shock proteins in ion channels trafficking to cell membrane has been recently described. Despite diffuse ST-T deviations having been described in patients with heat stroke, localized right precordial leads ST elevation consistent with Brugada syndrome have not been reported. Recognition of typical ECG pattern is of importance because this syndrome is associated to an increased risk of sudden cardiac death.
File Format	HTM / HTML
ISSN	07356757
Issue Number	5
Volume Number	27
e-ISSN	15328171
Journal	The American Journal of Emergency Medicine
Language	English
Publisher	Elsevier
Publisher Date	2009-06-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Emergency Discipline Medicine Brugada Syndrome Etiology Heat Stroke Complications Adult Physiopathology Electrocardiography Humans Male Case Reports Journal Article
Content Type	Text
Resource Type	Article Case study
Subject	Emergency Medicine

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