Type 1 Brugada Pattern Associated with Nicotine Toxicity.

Type 1 Brugada Pattern Associated with Nicotine Toxicity.

Ondrejka Jason; Giorgio Gary

The Journal of emergency medicine

2015

2015-12

BACKGROUND: Brugada pattern (BrP) findings on electrocardiogram (ECG) are mandatory for the diagnosis of Brugada syndrome (BrS). BrS is an incompletely understood cause of sudden cardiac death. CASE REPORT: Our patient was a young woman who was using topical nicotine for assistance in smoking cessation at a relatively high dose compared to her daily cigarette intake. She presented with symptoms of mild nicotine toxicity and had an ECG with a type 1 BrP. An ECG the next day was normal and electrophysiology consultation was conducted. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Recognition of a BrP ECG by emergency physicians is critical because this is the first step in diagnosing BrS, a condition that is characterized by ventricular dysrhythmias and sudden cardiac death. In addition, ECG abnormalities can be transient in nature, requiring vigilance by the emergency physician to prevent the patients' potential life threat from going undiagnosed. We present the first case to our knowledge of a BrP associated with nicotine toxicity. We also discuss treatment and disposition recommendations.

Adult; Adverse Drug Event; Behavior Rating Scales; Brugada pattern; Brugada syndrome; Brugada Syndrome – Chemically Induced; Brugada Syndrome – Diagnosis; Brugada Syndrome – Therapy; Brugada Syndrome/*chemically induced/*diagnosis/therapy; cardiac sodium channels; Drug-Related Side Effects and Adverse Reactions; electrocardiogram; Electrocardiography; Female; Humans; implanted cardioverter defibrillator; Nicotine; nicotine toxicity; Nicotine/*toxicity; sudden cardiac death; Tobacco Use Cessation Devices/*adverse effects; Tobacco Use Cessation Products – Adverse Effects

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