Document Detail

Heat stroke, an unusual trigger of Brugada electrocardiogram.
MedLine Citation:
PMID:  19497490     Owner:  NLM     Status:  MEDLINE    
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.
Javier Lacunza; Irene San Román; Sara Moreno; Esperanza García-Molina; Juan Gimeno; Mariano Valdés
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  27     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-05     Completed Date:  2009-07-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  634.e1-3     Citation Subset:  IM    
Department of Cardiology, University Hospital Virgen de la Arrixaca, 30120 Murcia, Spain.
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MeSH Terms
Brugada Syndrome / etiology*,  physiopathology
Heat Stroke / complications*,  physiopathology

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