Brugada electrocardiographic pattern in a postoperative patient.
OBJECTIVE
To report the development of the Brugada electrocardiographic (ECG) pattern in the immediate postoperative setting.


METHODS
Case report.


METHODS
Postanesthesia care unit at Memorial Sloan-Kettering Cancer Center.


METHODS
A 51-yr-old white male who developed new ST-segment elevation in leads V(1)-V(3) typical of the ECG changes of the Brugada syndrome immediately after undergoing head and neck surgery for cancer. The patient was asymptomatic, and the cardiac enzymes and echocardiogram were normal; therefore, electrophysiologic study was not performed.


CONCLUSIONS
We postulated that the Brugada ECG abnormalities were induced primarily by an increase in parasympathetic tone resulting from vagal nerve manipulation during deep neck dissection and partially by the fever he developed during the postoperative period. In addition to the more common causes of ST-segment elevation, the Brugada ECG pattern or syndrome should be considered in patients undergoing deep neck dissection who develop characteristic ECG changes in association with normal cardiac enzymes and echocardiogram.
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Alina
A
Dulu
Stephen M
SM
Pastores
Eileen
E
McAleer
Louis
L
Voigt
Neil A
NA
Halpern
D002037:Bundle-Branch Block / Q000209:etiology / Q000503:physiopathology*; D004562:Electrocardiography; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology*; D013577:Syndrome