Brugada syndrome in the presence of coronary artery disease and parasympathomimetic drug therapy.
Brugada pattern ECG changes have been described in various disease states and drug therapies, including electrolyte abnormalities, myocardial pathology, medications, and mechanical abnormalities. Therefore, the diagnosis of Brugada syndrome cannot be made in the presence of confounding variables according to prevailing guidelines. We present a case report which illustrates two important principles regarding Brugada syndrome, the dynamic ECG manifestations and the elimination of confounding variables (in this case significant coronary artery disease and cholinergic pharmacotherapy) prior to definitive diagnosis.
Krannert Institute of Cardiology, Indiana University School of Medicine, 1800 North Capitol Avenue, Indianapolis, IN 46202, USA.
Richard F
RF
Otten
Adrian C
AC
Dusa
Mithilesh K
MK
Das
D000889:Anti-Arrhythmia Agents; D001285:Atropine; D053840:Brugada Syndrome / Q000150:complications / Q000175:diagnosis* / Q000235:genetics; D002316:Cardiotonic Agents; D002800:Cholinesterase Inhibitors / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000235:genetics; D003937:Diagnosis, Differential; D004280:Dobutamine; D004452:Echocardiography; D004562:Electrocardiography; D005080:Exercise Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D011342:Procainamide; D011729:Pyridostigmine Bromide / Q000009:adverse effects*
D000889:Anti-Arrhythmia Agents; D002316:Cardiotonic Agents; D002800:Cholinesterase Inhibitors; D004280:Dobutamine; D001285:Atropine; D011729:Pyridostigmine Bromide; D011342:Procainamide