Journal Article

Brugada-like electrocardiographic pattern and ventricular fibrillation in a patient with primary hyperparathyroidism

Lung-Sheng Wu, Chia-Tung Wu, Lung-An Hsu, Nazar Luqman and Chi-Tai Kuo

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 9, issue 3, pages 172-174
Published in print March 2007 | ISSN: 1099-5129
Published online March 2007 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/eum002
Brugada-like electrocardiographic pattern and ventricular fibrillation in a patient with primary hyperparathyroidism

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There are several causes for ST segment abnormalities in leads V1 to V3. Hypercalcaemia and Brugada syndrome are among them. Both are known to produce ventricular arrhythmia, albeit only rare cases have been reported with documented evidence of ventricular arrhythmias in association with a hypercalcaemic crisis but none when hypercalcaemic coexists with Brugada syndrome. We describe a patient with primary hyperparathyroidism who presented with ventricular fibrillation, and the ECG showed changes similar to Brugada syndrome. The provocation test with flecainide was conducted twice. This was positive, both before and after parathyroidectomy when serum calcium and parathormone levels had normalized. The patient was treated for hypercalcaemia and underwent parathyroidectomy. This is the first report of oral flecainide test unmasking the diagnostic coved Brugada ECG pattern in a patient with primary hyperparathyroidism and raising attention to hypercalcaemia as a potential trigger for life-threatening arrhythmia in Brugada syndrome.

Keywords: Ventricular fibrillation; Hyperparathyroidism; Hypercalcaemia; Brugada syndrome

Journal Article.  1263 words.  Illustrated.

Subjects: Cardiovascular Medicine

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