Brugada pattern electrocardiogram unmasked with cocaine ingestion.
Cocaine is considered a leading cause of drug-related deaths. This is usually sudden, unwitnessed, and without prodromal features. It has been reported that in-hospital mortality is close to 2%. Cocaine has powerful central nervous system effects(1) and acute cocaine overdose has been associated with hyperthermia, agitation, paranoid ideation, status epilepticus, ventricular fibrillation, ventricular tachycardia, and myocardial infarction (MI). The mechanisms of cocaine-related death remain poorly understood. We report a patient who survived massive cocaine ingestion with psychomotor agitation and generalized seizures followed by asystolic cardiac arrest and transient Brugada pattern on electrocardiogram (ECG).
Department of Hospital Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 9500 Euclid Avenue, Mail Code A13, Cleveland, OH 44195, USA.
M Chadi
MC
Alraies
Department of Internal Medicine, Cleveland Clinic, Cleveland, OH 44195, USA.
Mohammed A R
MA
Chamsi-Pasha
Department of Hospital Medicine, Peninsula Regional Medical Center, Salisbury, MD 70118, USA.
Motaz
M
Baibars
Tulane University Health Sciences Center, Pulmonary Diseases, Critical Care and Environmental Medicine, New Orleans, LA, USA.
Abdul Hamid
AH
Alraiyes
Department of Hospital Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 9500 Euclid Avenue, Mail Code A13, Cleveland, OH 44195, USA.
Khaldoon
0000-0001-5208-1584
K
Shaheen