Type 1 electrocardiographic Brugada pattern in a woman with Chagas disease: a case report

Brito, Mitermayer Reis; Miranda, Carlos Eduardo Saraiva; Rabelo, Walter; Marino, Roberto Luiz

doi:10.1093/europace/euq129

Cited by 9 publications

(10 citation statements)

References 3 publications

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“…These manifestations usually disappear with cessation of the provoking event. Most common permanent conditions producing right precordial ST-elevation are: left ventricular hypertrophy, athlete’s heart, right bundle branch block (RBBB), pectus excavatum, septal hypertrophy, arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D), autonomic nervous system abnormalities, Duchenne-dystrophy, Friedreich’s ataxia, mediastinal tumor and Chagas disease 31, 58–60 . Some investigators have labelled these “phenocopies” indicating that they mimic the phenotype without a genetic predisposition.…”

Section: Clinical Characteristics and Diagnostic Criteriamentioning

confidence: 99%

Brugada Syndrome: Clinical, Genetic, Molecular, Cellular, and Ionic Aspects

Antzelevitch¹,

Patocskai²

2016

Current Problems in Cardiology

103

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The Brugada syndrome (BrS) is an inherited cardiac arrhythmia syndrome first described as a new clinical entity in 1992. Electrocardiographically characterized by distinct coved type ST segment elevation in the right precordial leads, the syndrome is associated with a high risk for sudden cardiac death in young adults, and less frequently in infants and children. The ECG manifestations of the BrS are often concealed and may be unmasked or aggravated by sodium channel blockers, a febrile state, vagotonic agents, as well as by tricyclic and tetracyclic antidepressants. An implantable cardioverter defibrillator (ICD) is the most widely accepted approach to therapy. Pharmacological therapy is designed to produce an inward shift in the balance of currents active during the early phases of the right ventricular action potential and can be used to abort electrical storms or as an adjunct or alternative to device therapy when use of an ICD is not possible. Isoproterenol, cilostazol and milrinone boost calcium channel current and drugs like quinidine, bepridil and the Chinese herb extract Wenxin Keli inhibit the transient outward current, acting to diminish the action potential (AP) notch and thus to suppress the substrate and trigger for VT/VF. Radiofrequency ablation of the right ventricular outflow tract epicardium of BrS patients has recently been shown to reduce arrhythmia-vulnerability and the ECG-manifestation of the disease, presumably by destroying the cells with more prominent AP notch. This review provides an overview of the clinical, genetic, molecular and cellular aspects of the BrS as well as the approach to therapy.

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Section: Clinical Characteristics and Diagnostic Criteriamentioning

confidence: 99%

Brugada Syndrome: Clinical, Genetic, Molecular, Cellular, and Ionic Aspects

Antzelevitch¹,

Patocskai²

2016

Current Problems in Cardiology

103

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“…Thirty‐one cases were identified as meeting our inclusion criteria 72–102 . To confirm these cases as manifestations of Brugada phenocopies, we first sought to assess the clinical probability that the patients had true Brugada syndrome.…”

Section: Resultsmentioning

confidence: 99%

“…The last category is Brugada phenocopies induced by myocardial and/or pericardial disease. This category includes six publications, describing nine patients 95–100 . Six patients showed Brugada Type‐1 ECG pattern whereas four had Type‐2.…”

Section: Resultsmentioning

confidence: 99%

“…Since then, several reports suggested that in some patients with Chagas’ disease; a Brugada Type‐1 ECG can be found 3 . Brito et al reported a case of a woman with a long‐time diagnosis of Chagas’ disease presenting with syncopal episodes and was found to have a Brugada Type‐1 ECG pattern upon further investigation 98 . The authors speculate the ECG findings are due to the pathological changes associated with Chagas’ disease, particularly in the right ventricle (dromotropic disorders).…”

Section: Discussionmentioning

confidence: 99%

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Brugada Phenocopy: New Terminology and Proposed Classification

Baranchuk

Nguyen

Ryu

et al. 2012

Noninvasive Electrocardiol

218

154

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Brugada syndrome is a channelopathy characterized on ECG by coved ST-segment elevation (≥2 mm) in the right precordial leads and is associated with an increased risk of malignant ventricular arrhythmias. The term Brugada phenocopy is proposed to describe conditions that induce Brugada-like ECG manifestations in patients without true Brugada syndrome. An extensive review of the literature identified case reports that were classified according to their suspected etiological mechanism. Future directions to learn more about these intriguing cases is discussed.

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“…The arrhythmogenic risk in these patients has not been clearly established and may prove to be difficult to determine in the future. First of all, this patients group is heterogeneous and incorporates various underlying cardiac conditions besides ARVC (Corrado et al, 1996, 2001; Tada et al, 1998; Peters et al, 2004): the Brugada ECG pattern can also occur in the setting of Chagas’ disease (Chiale et al, 1982; Brito et al, 2010). Thus far, prospective data are available of only 17 ARVC patients with drug-induced Brugada ECG (Peters, 2008) which is associated with a low arrhythmogenic risk in the setting of Brugada syndrome (Probst et al, 2010).…”

Section: Consequences Of the Overlapping Features Of Arvc And Brugadamentioning

confidence: 99%

Diagnostic Dilemmas: Overlapping Features of Brugada Syndrome and Arrhythmogenic Right Ventricular Cardiomyopathy

Hoogendijk¹

2012

Front. Physio.

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Arrhythmogenic right ventricular cardiomyopathy (ARVC) and Brugada syndrome are distinct clinical entities which diagnostic criteria exclude their coexistence in individual patients. ARVC is a myocardial disorder characterized by fibro-fatty replacement of the myocardium and ventricular arrhythmias. In contrast, the Brugada syndrome has long been considered a functional cardiac disorder: no gross structural abnormalities can be identified in the majority of patients and its electrocardiographic hallmark of coved-type ST-segment elevation in right precordial leads is dynamic. Nonetheless, a remarkable overlap in clinical features has been demonstrated between these conditions. This review focuses on this overlap and discusses its potential causes and consequences.

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Type 1 electrocardiographic Brugada pattern in a woman with Chagas disease: a case report

Cited by 9 publications

References 3 publications

Brugada Syndrome: Clinical, Genetic, Molecular, Cellular, and Ionic Aspects

Brugada Syndrome: Clinical, Genetic, Molecular, Cellular, and Ionic Aspects

Brugada Phenocopy: New Terminology and Proposed Classification

Diagnostic Dilemmas: Overlapping Features of Brugada Syndrome and Arrhythmogenic Right Ventricular Cardiomyopathy

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