Brugada Phenocopy in a Critical Obstetric Patient: A Case Report

TL;DR

A 30-year-old woman developed a Brugada phenocopy after a complicated cesarean section, caused by hyperkalemia and acidosis, which resolved with treatment.

Contribution

This case report presents a rare clinical scenario of Brugada phenocopy in a critical obstetric patient.

Findings

The patient's ECG pattern changed from type 1 to type 2 Brugada before normalizing after treatment.

Hyperkalemia and metabolic acidosis were identified as the reversible causes of the Brugada phenocopy.

Hemodialysis corrected the underlying disorders and resolved the ECG abnormalities.

Abstract

Brugada phenocopy (BrP) is an electrocardiographic (ECG) alteration that mimics Brugada syndrome (BrS) but lacks the associated genetic predisposition. It manifests as a transient pattern induced by reversible factors such as electrolyte imbalances, internal environment disturbances, and the use of certain drugs. In critically ill patients, hyperkalemia and acidosis are common triggers of this phenomenon, affecting ventricular repolarization and generating an ECG pattern identical to BrS. This report describes the case of a 30-year-old female patient who, following a complicated cesarean section with hemorrhagic shock, developed BrP induced by hyperkalemia and metabolic acidosis. The patient initially exhibited a type 1 Brugada ECG pattern, which evolved into a type 2 pattern and ultimately normalized after correction of the underlying disorders through hemodialysis. This case highlights the importance of an accurate differential diagnosis, as misidentifying BrP as true BrS could lead to inappropriate interventions, such as the implantation of defibrillators.

Figures