Brugada pattern induced by fever

A forty-nine year old female with a past medical history of myasthenia gravis, status post thymectomy and hypertension presented with fever of 103 F, pleuritic chest pain and cough. Interestingly, her ECG showed type 1 Brugada pattern (Fig. 1). She also gave a history of unexplained syncopal episodes for many years with inconclusive prior work up including a normal echocardiogram, stress test and Holter monitoring. She was treated for community acquired pneumonia. Her ECG returned to baseline in the next few days with improvement in her pneumonia and resolution of her fever (Fig. 2). Given type 1 Brugada ECG pattern induced by fever and unexplained syncope, an implantable defibrillator was placed after her infection was treated. Fever is a known trigger for ECG changes and cardiac arrest in patients with Brugada syndrome.¹ Commercial genetic testing did not identify a causative mutation for her Brugada EKG pattern.

Fig. 1.

ECG showing Brugada pattern on presentation with fever.

Fig. 2.

ECG showing resolution of Brugada pattern on treatment of pneumonia which was the cause of fever.

Conflicts of interest

All authors have none to declare.