Brugada phenocopy secondary to hyperkalemia and hyponatremia in primary adrenal insufficiency

Abstract Introduction The Brugada phenocopy represents electrocardiogram (ECG) changes nearly identical to the Brugada syndrome but without the congenital abnormality associated with lethal arrhythmias and normalizes with treatment of the underlying etiology. This case highlights the Brugada phenoco...

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Main Authors: Olga Amusina, Sandeep Mehta, Michael E. Nelson
Format: Article
Language:English
Published: Elsevier 2022-08-01
Series:Journal of the American College of Emergency Physicians Open
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Online Access:https://doi.org/10.1002/emp2.12800
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author Olga Amusina
Sandeep Mehta
Michael E. Nelson
author_facet Olga Amusina
Sandeep Mehta
Michael E. Nelson
author_sort Olga Amusina
collection DOAJ
description Abstract Introduction The Brugada phenocopy represents electrocardiogram (ECG) changes nearly identical to the Brugada syndrome but without the congenital abnormality associated with lethal arrhythmias and normalizes with treatment of the underlying etiology. This case highlights the Brugada phenocopy in the setting of moderate hyperkalemia and severe hyponatremia from adrenal insufficiency that resolves with treatment of the underlying metabolic disturbance. Case Report A 26‐year‐old man with no prior medical history presented to the emergency department with syncope, and his ECG revealed a Brugada‐like pattern. The patient was found to have significant metabolic derangements, including severe hyponatremia (94 mEq/L), moderate hyperkalemia (6.1 mEq/L), severe hypochloremia (<60 mEq/L), acute kidney injury, and rhabdomyolysis. The patient was diagnosed with primary adrenal insufficiency, and electrolyte correction led to resolution of the Brugada phenocopy. Conclusion The Brugada phenocopy on ECG can occur with severe hyponatremia and moderate hyperkalemia and quickly resolves with electrolyte correction.
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spelling doaj-art-e4228945a505404cbe8371aba17471b92025-08-20T02:04:25ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522022-08-0134n/an/a10.1002/emp2.12800Brugada phenocopy secondary to hyperkalemia and hyponatremia in primary adrenal insufficiencyOlga Amusina0Sandeep Mehta1Michael E. Nelson2NorthShore University HealthSystem Evanston Illinois USANorthShore University HealthSystem Evanston Illinois USANorthShore University HealthSystem Evanston Illinois USAAbstract Introduction The Brugada phenocopy represents electrocardiogram (ECG) changes nearly identical to the Brugada syndrome but without the congenital abnormality associated with lethal arrhythmias and normalizes with treatment of the underlying etiology. This case highlights the Brugada phenocopy in the setting of moderate hyperkalemia and severe hyponatremia from adrenal insufficiency that resolves with treatment of the underlying metabolic disturbance. Case Report A 26‐year‐old man with no prior medical history presented to the emergency department with syncope, and his ECG revealed a Brugada‐like pattern. The patient was found to have significant metabolic derangements, including severe hyponatremia (94 mEq/L), moderate hyperkalemia (6.1 mEq/L), severe hypochloremia (<60 mEq/L), acute kidney injury, and rhabdomyolysis. The patient was diagnosed with primary adrenal insufficiency, and electrolyte correction led to resolution of the Brugada phenocopy. Conclusion The Brugada phenocopy on ECG can occur with severe hyponatremia and moderate hyperkalemia and quickly resolves with electrolyte correction.https://doi.org/10.1002/emp2.12800adrenal insufficiencyBrugada phenocopycase reporthyperkalemiahyponatremia
spellingShingle Olga Amusina
Sandeep Mehta
Michael E. Nelson
Brugada phenocopy secondary to hyperkalemia and hyponatremia in primary adrenal insufficiency
Journal of the American College of Emergency Physicians Open
adrenal insufficiency
Brugada phenocopy
case report
hyperkalemia
hyponatremia
title Brugada phenocopy secondary to hyperkalemia and hyponatremia in primary adrenal insufficiency
title_full Brugada phenocopy secondary to hyperkalemia and hyponatremia in primary adrenal insufficiency
title_fullStr Brugada phenocopy secondary to hyperkalemia and hyponatremia in primary adrenal insufficiency
title_full_unstemmed Brugada phenocopy secondary to hyperkalemia and hyponatremia in primary adrenal insufficiency
title_short Brugada phenocopy secondary to hyperkalemia and hyponatremia in primary adrenal insufficiency
title_sort brugada phenocopy secondary to hyperkalemia and hyponatremia in primary adrenal insufficiency
topic adrenal insufficiency
Brugada phenocopy
case report
hyperkalemia
hyponatremia
url https://doi.org/10.1002/emp2.12800
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AT michaelenelson brugadaphenocopysecondarytohyperkalemiaandhyponatremiainprimaryadrenalinsufficiency