Propranolol intoxication revealing a Brugada syndrome.
This is the first report of Brugada syndrome revealed by beta-blocker intoxication. A 24-year-old healthy man ingested propranolol (2.28 g) to commit suicide. After early gastric lavage, electrolytes, cardiac enzymes, chest X-ray, and echocardiography were normal. Dosages of psychotropic drugs were negative. ECG showed a typical coved-type pattern of Brugada syndrome. Follow-up showed partial ECG normalization of the discrete saddleback-type pattern. The ajmaline- test confirmed Brugada syndrome. These ECG modifications may be explained by the stabilizing membrane effect of high concentration of propranolol and/or inhibition of ICaL. This case illustrates the possible deleterious effects of beta-blockers in patients with Brugada syndrome.
Aouate
Philip
P
Arrhythmias Department, Laënnec Hospital, Creil, France. Philip.aouate@ch-creil.fr
Clerc
Jerome
J
Viard
Philippe
P
Seoud
Jamal
J
D000319:Adrenergic beta-Antagonists / Q000633:toxicity*; D000328:Adult; D001285:Atropine / Q000627:therapeutic use; D002037:Bundle-Branch Block / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D004562:Electrocardiography; D005934:Glucagon / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011433:Propranolol / Q000633:toxicity*; D013406:Suicide, Attempted; D013577:Syndrome; D014693:Ventricular Fibrillation / Q000139:chemically induced* / Q000503:physiopathology
D000319:Adrenergic beta-Antagonists; D001285:Atropine; D005934:Glucagon; D011433:Propranolol