SHM Converge Scientific Abstract ePoster Gallery-The True Heart Stopper: Brugada Syndrome Presenting in Covid-19

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This case describes a 19-year-old previously healthy male who presented to the ED after being found unresponsive and diaphoretic. He was tachycardic, had respiratory failure requiring intubation, and later developed pulseless ventricular fibrillation with return of spontaneous circulation after CPR. Initial ECG showed only sinus tachycardia, but a repeat ECG just before arrest revealed a type 1 Brugada pattern with coved ST elevation in V1–V3 and inverted T waves. Subsequent ECGs showed resolution of the pattern. He was found to be COVID-19 positive with multilobar pneumonia and inflammatory lab abnormalities. Despite resuscitation, he ultimately died from anoxic brain injury.<br /><br />The report highlights Brugada syndrome, a male-predominant inherited arrhythmia disorder with a prevalence of about 0.1–1%. It increases the risk of ventricular tachyarrhythmias and sudden cardiac death in patients with structurally normal hearts. Diagnosis is made by recognizing the characteristic pseudo-right bundle branch block and ST-segment changes in leads V1 and V2, though ECG findings may be transient and therefore missed. Common triggers include fever, medications/drugs such as cocaine, and infections including COVID-19.<br /><br />The case emphasizes that COVID-19-related fever and illness can unmask Brugada syndrome in young patients without prior cardiac history. Management includes close ECG monitoring, consideration of implantable cardioverter-defibrillator placement in high-risk patients, and catheter ablation in selected cases. The key lesson is to maintain a high index of suspicion for Brugada syndrome in febrile or infected patients who develop unexplained syncope, arrhythmia, or cardiac arrest.

Asset Subtitle

Michael C. Kim

Meta Tag

Author List Dylan Lopez, Manavjot Sidhu, Michael C. Kim

Category Clinical Vignettes

Concept Brugada syndrome

Concept Type 1 coved pattern

Concept Ventricular tachyarrhythmia

Concept Sickle Cell Disease

Concept Cardiac Arrest

Distinguished Non-Finalist

Presenter Organization Methodist Dallas Medical Center

Presenting Author Michael C. Kim

Track Adult

Keywords

Brugada syndrome

COVID-19

ventricular fibrillation

sudden cardiac death

type 1 Brugada pattern

ECG abnormalities

fever trigger

young male

cardiac arrest

anoxic brain injury

Brugada syndrome

Type 1 coved pattern

Ventricular tachyarrhythmia

Sickle Cell Disease

Cardiac Arrest