Brugada phenocopy: Mechanisms, diagnosis, and implications

Neto, Nestor Rodrigues de Oliveira; Oliveira, William Santos de; Mastrocola, Fabio; Sacilotto, Luciana

doi:10.1016/j.jelectrocard.2019.04.017

Cited by 44 publications

(36 citation statements)

References 55 publications

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“…BrS is an autosomal dominant genetic channelopathy that is associated with sudden cardiac death (SCD) secondary to ventricular tachyarrhythmia in the setting of a structurally normal heart [1][2][3]. It is inherited in an autosomal dominant pattern with variable penetrance with male predominance [4,5].…”

Section: Discussionmentioning

confidence: 99%

“…The International Registry of Brugada Phenocopies have proposed an algorithm which allows for appropriate diagnosis of BrP (Figure 3) [11]. Of most importance in the algorithm is the provocation/challenge test with sodium channel blockers [1,5]. These medications act by blocking predominantly sodium currents thus increasing the alreadypresent ionic imbalance.…”

Section: Discussionmentioning

confidence: 99%

“…BrS is an autosomal dominant genetic disorder that is associated with sudden cardiac death (SCD) secondary to ventricular tachyarrhythmia in the setting of a structurally normal heart [1]. It is characterized by three morphologic phenotypes.…”

Section: Introductionmentioning

confidence: 99%

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Brugada Phenocopy Type 1 Secondary to Synthetic Cannabinoids

Amro

Okoro

Mansoor

et al. 2020

Case Reports in Cardiology

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Brugada phenocopies (BrP) are clinical entities that have EKG tracings similar to the congenital Brugada syndrome (BrS) but without ventricular tachyarrhythmias or sudden cardiac death. BrP is caused by various factors such as metabolic disturbances (electrolyte imbalance), drugs, mechanical compression of the mediastinum, and inflammatory conditions such as myocarditis or pericarditis. We present a very rare case of a young patient who had a Brugada phenocopy Type 1 suspected to be secondary to synthetic cannabinoids.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Brugada Phenocopy Type 1 Secondary to Synthetic Cannabinoids

Amro

Okoro

Mansoor

et al. 2020

Case Reports in Cardiology

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“…The descending ST segment crosses the isoelectric line and is followed by a negative and symmetrical T wave 1 .…”

Section: Introductionmentioning

confidence: 99%

“…The Haller index estimates the severity of pectus excavatum, where values > 3.25 denote severe compression. In moderate to severe cases, spirometry may show restrictive ventilatory disorder due to a decrease in intrathoracic volume with a consequent reduction of lung volumes caused by compression of pectus excavatum 3,5,6 .Also, patients with mechanical compression Brugada phenocopy who remain only with type 2 electrocardiographic patterns do not evolve to type 1 spontaneously or after using antiarrhythmic sodium channel blockers1,5 .…”

mentioning

confidence: 99%

Brugada Syndrome or Phenocopy? Diagnostic Challenge in Patients with Pectus Excavatum

Luciano

Goldoni

Sales

et al. 2020

J Cardiac Arrhtythmias

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Brugada syndrome is an autosomal dominant heart disease caused by dysfunctions in the ionic channels, whose carriers present a classic electrocardiographic pattern and predisposition to malignant ventricular arrhythmias. The electrocardiogram alterations may be dynamic, spontaneous, or induced by sodium channel blocking drugs (ajmaline, procainamide, etc.). However, electrocardiographic findings that diagnose Brugada syndrome may occur even in the absence of congenital dysfunction of ionic channels, characterizing “Brugada phenocopy”, therefore the exclusion of secondary causes is fundamental for the correct diagnosis of channelopathy.

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Brugada Electrocardiographic Pattern in an Older Man With Syncope

Zhai

2021

JAMA Intern Med

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A 61-year-old man with no history of heart or lung disease was admitted for benign prostatic hyperplasia surgery. On presentation, his physical examination findings were normal. His hemogram results and serum electrolyte levels were within normal limits. A 12-lead electrocardiogram (ECG) was obtained (Figure , A) at the time of admission. After a day of postoperative bed rest, he experienced sudden dyspnea and syncope while going to the toilet. His blood pressure was 75/38 mm Hg, and his peripheral oxygen saturation was 87% while breathing room air. There was obvious jugular venous distention. A repeated ECG is shown in the Figure , B.Questions: What are the clinically significant findings on the ECG in the Figure , B? What is the most likely diagnosis? InterpretationThe baseline 12-lead ECG shows sinus rhythm without obvious ST-T deviation. The repeated ECG shows atrial fibrillation (160 beats/ min) with rapid ventricular response, right axis deviation, S1Q3T3 pattern, ST-segment depression in leads V 4 to V 6 , ST-segment elevation in leads III, V 1 , and V 2 , and additional T-wave inversions in leads V 1 and V 2 that mimic a type 1 Brugada ECG pattern (named Brugada phenocopy [BrP]). All these ECG changes suggest a degree of right ventricular (RV) strain. Clinical CourseThe history of postoperative bed rest, signs of RV strain on the ECG, and dyspnea associated with syncope raised high suspicion of Figure. Electrocardiogram (ECG) Findings Admission ECG A Postsurgical ECG B A, Admission ECG showing sinus rhythm without obvious ST-T deviation. B, Postsurgical ECG showing ST-segment elevation on right precordial leads V 1 and V 2 that mimics a type 1 Brugada ECG pattern.

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Brugada phenocopy: Mechanisms, diagnosis, and implications

Cited by 44 publications

References 55 publications

Brugada Phenocopy Type 1 Secondary to Synthetic Cannabinoids

Brugada Phenocopy Type 1 Secondary to Synthetic Cannabinoids

Brugada Syndrome or Phenocopy? Diagnostic Challenge in Patients with Pectus Excavatum

Brugada Electrocardiographic Pattern in an Older Man With Syncope

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