introduction: Brugada syndrome was described in 1992 as a new clinical and electrocardiographic syndrome with susceptibility to ventricular arrhythmias and sudden cardiac death in patients without overt structural heart disease. Brugada phenocopy (BrP) is an evolved term that refers to Brugada-like ECG patterns due to reversible causes. This article describes the case of a patient who presented with a transient Brugada pattern after a scorpion sting.
Case report: A 65-year-old woman with cardiovascular risk factors of age and menopause, but no significant medical history, presented to the emergency department complaining of unusual chest pain 5 hours after being stung by a scorpion. She had no associated symptoms such as dyspnea, syncope, or palpitations, and no personal or family history of sudden death. On admission, she was conscious, hemodynamically stable, normotensive and tachycardic, with no signs of heart failure. Her ECG showed a 2 mm elevation at point J and inverted T waves in V1 and V2, with a Brugada pattern. She was admitted to the ICU for close monitoring. Echocardiography revealed normal left and right ventricular function. Laboratory tests showed negative troponin, normal blood ionogram, and normal renal and liver function. The Brugada pattern resolved within a few hours and the patient’s condition stabilized.
Discussion and conclusion: Our case highlights the importance of performing a thorough medical history to exclude the presence of a family history of arrhythmia, syncope, or sudden cardiac death in similar situations. If the medical history is concerning, cardiological follow-up is essential to investigate the possibility of Brugada syndrome. Performing a follow-up ECG at discharge is beneficial to confirm the reversibility of the findings. This distinction is very important because it helps distinguish between Brugada syndrome and Brugada pattern, the latter a condition that can occur in patients who have had a scorpion sting or other triggers.
Zerhoudi, Lim, Caoura Bourzeg, Ayoub Moussineh, Jumana Elmaslioui, Mohamed El Jamili, Sofia Oubaha, Mustafa Elhattaoui. 2024. “Temporary Brugada Like a Scorpion Sting: An Unexpected Connection.” Cardiology and Vasculology: An International Journal 13(4):111-15. https://doi.org/10.9734/ca/2024/v13i4450.
