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Fever in an elderly patient unmasks Brugada syndrome
Febre num idoso desmascara síndrome de Brugada
Sofia Lázaro Mendes, , Luís Elvas, Domingos Ramos, Mariano Pêgo
Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
Received 19 March 2016, Accepted 26 July 2016

A 74-year-old man was admitted to the emergency department after experiencing a syncopal episode followed by ventricular fibrillation witnessed by the medical emergency team. After defibrillation and one round of cardiopulmonary resuscitation, the patient regained spontaneous circulation. He had presented malaise and fever during the night. His blood pressure was 125/78 mmHg, his oxygen saturation was 96% on room air and his temperature was 38.2°C. An electrocardiogram (ECG) at admission demonstrated a coved ST-segment elevation in V1 and V2 followed by a negative T wave, compatible with type 1 Brugada pattern (Figure 1). There was no family history of sudden death or heart disease. His previous ECG, performed six months previously, was essentially normal (Figure 2). The transthoracic echocardiogram excluded structural heart disease. Coronary angiography excluded coronary disease. He was admitted to the cardiac care unit for closer monitoring. Repeat ECG 24 hours later in apyrexia showed complete normalization. The infection was resolved and a cardioverter-defibrillator was implanted before discharge.

Figure 1.
(0.17MB).

Electrocardiogram at admission showing coved ST-segment elevation in V1 and V2 followed by a negative T wave.

Figure 2.
(0.12MB).

Previous electrocardiogram performed six months previously (essentially normal).

Ethical disclosuresProtection of human and animal subjects

The authors declare that no experiments were performed on humans or animals for this study.

Confidentiality of data

The authors declare that no patient data appear in this article.

Right to privacy and informed consent

The authors declare that no patient data appear in this article.

Conflicts of interest

The authors have no conflicts of interest to declare.


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  • Impact Factor: 1.195(2016)
  • SCImago Journal Rank (SJR):0,24
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