Brugada-Like Electrocardiographic Patterns Induced by Hyperkalemia

Abstract

Brugada syndrome was described in 1992 as a new clinical and electrocardiographic syndrome involving susceptibility to ventricular arrhythmias and sudden cardiac death in patients with no obvious structural heart disease. Brugada syndrome is characterized by a hereditary anomaly in the sodium ion channel (mutation of the SCN5A gene) identified by a wide QRS associated with the ST-segment elevation and the T‑wave inversion in the right precordial leads. The Brugada-like electrocardiographic pattern can be caused by sodium channel-blocking drugs and electrolyte disorders. Hyperkalemia may produce multiple ECG abnormalities, including the ST-segment elevation and pseudomyocardial infarction with a resolution of these abnormalities after the correction of hyperkalemia. This article describes 8 cases of pseudoanteroseptal myocardial infarction in acute renal insufficiency with hyperkalemia. The ST-segment elevation related to hyperkalemia is resolved by the reduced serum potassium level. Clinicians should recognize that hyperkalemia is one of the etiologies of the Brugada-like electrocardiographic pattern.

Electrocardiographic abnormalities associated with acute glyphosate toxicity

“…The ECG abnormalities on presentation (Figure 1) can be observed in severe hyperkalemia as well as tricyclic antidepressant overdose. [6][7][8] However, the patient's potassium level, which was drawn prior to any treatments given, was normal at 4.8 mmol/L (lab reference range 3.5-5.3 mmol/L) at time of admission and remained normal during the hospitalization. Magnesium levels were also within normal limits.…”