Drug-induced pericarditis mimicking Brugada syndrome.
Brugada syndrome (BS) is associated with sudden cardiac death in patients with a structurally normal heart. The ECG pattern of BS has also been described in patients with myocardial abnormalities. Cardiac hypersensitivity and myopericarditis have been reported during long-term treatment with mesalazine. We report the case of a man, treated with mesalazine for Crohn's disease who developed drug-induced pericarditis. The ECG showed a coved ST-segment elevation in the right precordial leads V1-V3, a pattern mimicking BS. The ECG normalized in a few days after mesalazine withdrawal and the follow-up was uneventful. The ECG remained normal. Two ajmaline tests were both negative and ruled out the diagnosis of BS. This observation illustrates that a coved ST-segment elevation in the right precordial leads should not be, systematically, regarded as a marker of a specific syndrome, but may also reflect a common electrical manifestation of abnormalities in the right ventricle or pericardium.
Hermida
Jean-Sylvain
JS
Cardiology Department, Amiens-Picardie University Hospital, Service de Cardiologie A, Groupe Hospitalier Sud, Avenue René Laënnec, 80054 Amiens Cedex 1, France. hermida.jean-sylvain@chu-amiens.fr
Six
Isabelle
I
Jarry
Geneviève
G
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D053840:Brugada Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D003424:Crohn Disease / Q000188:drug therapy; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D008297:Male; D019804:Mesalamine / Q000009:adverse effects* / Q000627:therapeutic use; D010493:Pericarditis / Q000139:chemically induced* / Q000175:diagnosis* / Q000503:physiopathology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D019804:Mesalamine