STEMI-mimic: Brugada Pattern or Brugada Phenocopy

A 70 yo with h/o of HTN c/o of fever.

Image 1-12 lead ECG

The rhythm is sinus tachycardia with ST elevations in V1 and V2. The initial interpretation was concerning for a STEMI. Cardiac cath was negative for any significant coronary occlusion. The investigation for fever was pursued.

Typical teaching would say that this could be septal MI but this ECG pattern is that of a Brugada ECG pattern (esp. type 1). 

Brugada syndrome of true congenital Brugada syndrome is sudden cardiac death syndrome with characteristic ECG pattern namely type 1 and type 2. This ECG pattern predisposes individuals to malignant ventricular arrhythymias. Other conditions can mimic this 2 ECG patterns. Thus the term Brugada pattern is used or Brugada phenocopy. A group/site dedicated to Brugada phenocopy can be found on this site - http://www.brugadaphenocopy.com/

Image 2 - Brugada Patterns

#619