Lithium-induced ECG modifications: navigating from acute coronary syndrome to Brugada syndrome

Abstract

Lithium is frequently used in the treatment of bipolar disorders and is known to induce ECG alterations. This case study describes various patterns of lithium-induced ECG modifications in a patient with acute-on-chronic lithium intoxication. Clinicians should be familiar with this problem as it can have life-threatening consequences and lead to important changes in patient’s management. Our patient was admitted for acute delirium with an ECG showing atrial fibrillation with wide QRS and ST-segment elevation. These modifications were first mistaken for an acute myocardial infarction and a diagnosis of Brugada syndrome was finally reached. Treatment after the acute phase implied changes in the therapeutic modality and required frequent monitoring.

Metals and Metal-Nanoparticles in Human Pathologies: From Exposure to Therapy

“…Lithium is frequently used in the treatment of bipolar disorders, but it is also known to induce electrocardiogram (ECG) alterations and cardiotoxicity including sinus node dysfunction [33,34]. When prescribing lithium, the risk of toxicity remains a concern.…”

Lithium Treatment Induces Cardiac Dysfunction in Mice

“…Li-induced cardiac toxicity can result in electrocardiographic (ECG) alterations, including dysrhythmias, prolonged QT interval, T wave flattening, and the Brugada ECG pattern. In rare cases, it can lead to moderate systolic dysfunction [15], heart attack, and heart arrest [16][17][18][19].…”