# Hypokalemia-induced Type 1 Brugada Reveals Type 3 Brugada Pattern with Repletion: Case Report

## TL;DR

A patient with severe low potassium showed a Brugada heart pattern, which changed after potassium was restored.

## Contribution

Demonstrates how hypokalemia can trigger and mask Brugada patterns, with implications for emergency treatment.

## Key findings

- Severe hypokalemia revealed type 1 Brugada pattern on ECG in a patient.
- Potassium repletion shifted the ECG pattern to type 3 Brugada and then resolved.
- Correcting metabolic imbalances can reveal and resolve Brugada patterns in the ED.

## Abstract

Brugada syndrome is a ventricular arrhythmia and type of sodium channelopathy that can be seen in the absence of structural heart disease. Recognition of this pattern on electrocardiogram (ECG) is important for stabilization and correction of underlying triggers that can be addressed in the emergency department (ED).

We describe a case of a 58-year-old male who presented with chest pain and was found to have type 1 Brugada pattern in the setting of severe hypokalemia. Repletion of potassium later revealed type 3 Brugada pattern followed by resolution on repeat ECG.

Rapid identification of underlying metabolic derangements that can trigger Brugada syndrome is important in the ED setting. Correction of the underlying abnormality can reveal a type 3 pattern with subsequent resolution of the pattern if well-controlled.