Brugada electrocardiographic phenocopy in a patient with chronic Chagasic cardiomyopathy

Mauricio Arce, Andrés Ricardo Pérez Riera, Francisco Femenía, Adrián Baranchuk
2010 Cardiology Journal  
A 44 year-old male with a history of chronic Chagasic cardiomyopathy (CChC) (exclusively dromotropic form), systemic hypertension and centripetal obesity, presented for a routine electrocardiogram (ECG). There was no history of syncope or sudden death and no evidence of heart failure. Laboratory tests were within normal ranges. There was a positive serological test for Chagas' disease. There was no family history of cardiovascular disease and both parents had normal ECGs. His medication
more » ... medication included enalapril 10 mg twice a day and hydrochlorothiazide 25 mg daily. His echocardiogram showed moderate concentric left ventricular hypertrophy (interventricular septum and posterior free wall of 14 mm) and signs of decreased ventricular compliance. His 12-lead ECG showed ( Fig. 1) : sinus rhythm, heart rate 57 bpm, prolonged P-wave du- Figure 1 . Sinus rhythm, heart rate 57 bpm, P-wave duration 120 ms, normal PR interval (160 ms), right QRS axis deviation (+120°) and prolonged QRS duration (160 ms). Left posterior fascicular block: rS in lead I and aVL; qR pattern in leads II, III and aVF; R-wave in III > II, q-wave in III > q II. Complete right bundle branch block: QRS duration ≥ 120 ms; rsR' pattern in lead V1; broad S-wave in left leads I and aVL with a duration greater than 40 ms. QT interval 360 ms and QTc 350 ms. A Brugada-type 1 ECG pattern ('coved-type') can be seen in leads V1 and V2.
pmid:20865687 fatcat:rg2fcwqhtbfpxd7z4psxesnyfm