Cardiac Arrest Due to Brugada Syndrome Associated With Influenza Infection: A Case Report and Literature Review
A 38-year-old Japanese male with no significant medical history but a family history of sudden cardiac death was referred for cardiac arrest. He had a fever (40°C) one day before his visit. His wife reported that he groaned while unconscious, which prompted a referral to the authors' hospital....
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description | A 38-year-old Japanese male with no significant medical history but a family history of sudden cardiac death was referred for cardiac arrest. He had a fever (40°C) one day before his visit. His wife reported that he groaned while unconscious, which prompted a referral to the authors' hospital. He was febrile and experienced ventricular fibrillation in the emergency department. After the resolution of ventricular fibrillation, electrocardiography revealed a right bundle branch block with ST-segment elevation in leads V1-3, consistent with a Brugada electrocardiographic pattern; he also tested positive for influenza A infection. Antiarrhythmic and antipyretic agents were administered, and peramivir was initiated; a fatal arrhythmia did not occur. A cardioverter-defibrillator was implanted, and the patient was discharged without complications. Brugada syndrome is a genetic disease that causes fatal cardiac arrhythmias, with fever recognized to induce the Brugada electrocardiographic pattern. The mechanism of the Brugada-type electrocardiographic pattern, right bundle branch block, and ST-segment elevation in the right precordial leads is considered to be the result of an outward shift of ionic currents during early repolarization, causing a marked abbreviation of the action potential in epicardial cells of the right ventricle. Activation and inactivation kinetics for early sodium currents are faster at higher temperatures. To date, there have only been four published reports describing Brugada-like electrocardiographic changes associated with fever related to influenza infection, and this is the first report of cardiac arrest. Since influenza infection can cause high fever and trigger the fetal arrhythmia of Brugada syndrome, it is important to shorten the duration of the fever. Anti-influenza therapy may be considered in patients who have a history of sudden cardiac arrest in the family, as influenza may influence the development of the Brugada ECG pattern in these individuals. The authors also review the literature on Brugada-like electrocardiographic changes induced by influenza infection. Physicians should be aware that Brugada's electrocardiographic pattern and cardiac arrest can be caused by febrile episodes, including those related to influenza infection. |
doi_str_mv | 10.7759/cureus.37158 |
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He had a fever (40°C) one day before his visit. His wife reported that he groaned while unconscious, which prompted a referral to the authors' hospital. He was febrile and experienced ventricular fibrillation in the emergency department. After the resolution of ventricular fibrillation, electrocardiography revealed a right bundle branch block with ST-segment elevation in leads V1-3, consistent with a Brugada electrocardiographic pattern; he also tested positive for influenza A infection. Antiarrhythmic and antipyretic agents were administered, and peramivir was initiated; a fatal arrhythmia did not occur. A cardioverter-defibrillator was implanted, and the patient was discharged without complications. Brugada syndrome is a genetic disease that causes fatal cardiac arrhythmias, with fever recognized to induce the Brugada electrocardiographic pattern. The mechanism of the Brugada-type electrocardiographic pattern, right bundle branch block, and ST-segment elevation in the right precordial leads is considered to be the result of an outward shift of ionic currents during early repolarization, causing a marked abbreviation of the action potential in epicardial cells of the right ventricle. Activation and inactivation kinetics for early sodium currents are faster at higher temperatures. To date, there have only been four published reports describing Brugada-like electrocardiographic changes associated with fever related to influenza infection, and this is the first report of cardiac arrest. Since influenza infection can cause high fever and trigger the fetal arrhythmia of Brugada syndrome, it is important to shorten the duration of the fever. Anti-influenza therapy may be considered in patients who have a history of sudden cardiac arrest in the family, as influenza may influence the development of the Brugada ECG pattern in these individuals. The authors also review the literature on Brugada-like electrocardiographic changes induced by influenza infection. Physicians should be aware that Brugada's electrocardiographic pattern and cardiac arrest can be caused by febrile episodes, including those related to influenza infection.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.37158</identifier><identifier>PMID: 37168174</identifier><language>eng</language><publisher>United States: Cureus Inc</publisher><subject>Analgesics ; Body temperature ; Cardiac arrest ; Cardiac arrhythmia ; Cardiology ; Case reports ; Consciousness ; Electrocardiography ; Electrolytes ; Emergency Medicine ; Enzymes ; Family medical history ; Fever ; Infections ; Infectious Disease ; Influenza ; Kinases ; Mutation ; Patients ; Potassium ; Sodium</subject><ispartof>Curēus (Palo Alto, CA), 2023-04, Vol.15 (4), p.e37158</ispartof><rights>Copyright © 2023, Ono et al.</rights><rights>Copyright © 2023, Ono et al. This work is published under https://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2023, Ono et al. 2023 Ono et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c1828-3f85b579548fcf0a88d04eca5b228ee1e987f3f47d4387f6baea221bb7ed69893</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166275/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10166275/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,886,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37168174$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ono, Ryohei</creatorcontrib><creatorcontrib>Hori, Yasuhiko</creatorcontrib><creatorcontrib>Yamazaki, Tatsuro</creatorcontrib><creatorcontrib>Takahashi, Hidehisa</creatorcontrib><creatorcontrib>Fukushima, Kenichi</creatorcontrib><title>Cardiac Arrest Due to Brugada Syndrome Associated With Influenza Infection: A Case Report and Literature Review</title><title>Curēus (Palo Alto, CA)</title><addtitle>Cureus</addtitle><description>A 38-year-old Japanese male with no significant medical history but a family history of sudden cardiac death was referred for cardiac arrest. He had a fever (40°C) one day before his visit. His wife reported that he groaned while unconscious, which prompted a referral to the authors' hospital. He was febrile and experienced ventricular fibrillation in the emergency department. After the resolution of ventricular fibrillation, electrocardiography revealed a right bundle branch block with ST-segment elevation in leads V1-3, consistent with a Brugada electrocardiographic pattern; he also tested positive for influenza A infection. Antiarrhythmic and antipyretic agents were administered, and peramivir was initiated; a fatal arrhythmia did not occur. A cardioverter-defibrillator was implanted, and the patient was discharged without complications. Brugada syndrome is a genetic disease that causes fatal cardiac arrhythmias, with fever recognized to induce the Brugada electrocardiographic pattern. The mechanism of the Brugada-type electrocardiographic pattern, right bundle branch block, and ST-segment elevation in the right precordial leads is considered to be the result of an outward shift of ionic currents during early repolarization, causing a marked abbreviation of the action potential in epicardial cells of the right ventricle. Activation and inactivation kinetics for early sodium currents are faster at higher temperatures. To date, there have only been four published reports describing Brugada-like electrocardiographic changes associated with fever related to influenza infection, and this is the first report of cardiac arrest. Since influenza infection can cause high fever and trigger the fetal arrhythmia of Brugada syndrome, it is important to shorten the duration of the fever. Anti-influenza therapy may be considered in patients who have a history of sudden cardiac arrest in the family, as influenza may influence the development of the Brugada ECG pattern in these individuals. The authors also review the literature on Brugada-like electrocardiographic changes induced by influenza infection. Physicians should be aware that Brugada's electrocardiographic pattern and cardiac arrest can be caused by febrile episodes, including those related to influenza infection.</description><subject>Analgesics</subject><subject>Body temperature</subject><subject>Cardiac arrest</subject><subject>Cardiac arrhythmia</subject><subject>Cardiology</subject><subject>Case reports</subject><subject>Consciousness</subject><subject>Electrocardiography</subject><subject>Electrolytes</subject><subject>Emergency Medicine</subject><subject>Enzymes</subject><subject>Family medical history</subject><subject>Fever</subject><subject>Infections</subject><subject>Infectious Disease</subject><subject>Influenza</subject><subject>Kinases</subject><subject>Mutation</subject><subject>Patients</subject><subject>Potassium</subject><subject>Sodium</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpVkc1PGzEQxa2qqEHArefKEtcGbO-HvVyqEL4iRUJqizhas_YsOErWqe0FwV-PaQCFk588P715mkfId86OpKyaYzMEHOJRIXmlvpBdwWs1VlyVX7f0iBzEuGCMcSYFk-wbGWW-VlyWu8RPIVgHhk5CwJjo2YA0eXoahjuwQP889Tb4FdJJjN44SGjprUv3dNZ3ywH7Z3hVaJLz_Qmd0ClEpL9x7UOi0Fs6dwkDpJwy_z44fNwnOx0sIx68vXvk5uL87_RqPL--nE0n87HhSqhx0amqrWRTlaozHQOlLCvRQNUKoRA5Nkp2RVdKWxZZ1S0gCMHbVqKtG9UUe-TXxnc9tCu0BvsUYKnXwa0gPGkPTn-e9O5e3_kHzRmvayGr7HD45hD8vyHfRi_8EPocWgsluKiLpuKZ-rmhTPAxBuw-VnCmXyvSm4r0_4oy_mM71gf8XkjxAk1ujvw</recordid><startdate>20230405</startdate><enddate>20230405</enddate><creator>Ono, Ryohei</creator><creator>Hori, Yasuhiko</creator><creator>Yamazaki, Tatsuro</creator><creator>Takahashi, Hidehisa</creator><creator>Fukushima, Kenichi</creator><general>Cureus Inc</general><general>Cureus</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope></search><sort><creationdate>20230405</creationdate><title>Cardiac Arrest Due to Brugada Syndrome Associated With Influenza Infection: A Case Report and Literature Review</title><author>Ono, Ryohei ; Hori, Yasuhiko ; Yamazaki, Tatsuro ; Takahashi, Hidehisa ; Fukushima, Kenichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1828-3f85b579548fcf0a88d04eca5b228ee1e987f3f47d4387f6baea221bb7ed69893</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Analgesics</topic><topic>Body temperature</topic><topic>Cardiac arrest</topic><topic>Cardiac arrhythmia</topic><topic>Cardiology</topic><topic>Case reports</topic><topic>Consciousness</topic><topic>Electrocardiography</topic><topic>Electrolytes</topic><topic>Emergency Medicine</topic><topic>Enzymes</topic><topic>Family medical history</topic><topic>Fever</topic><topic>Infections</topic><topic>Infectious Disease</topic><topic>Influenza</topic><topic>Kinases</topic><topic>Mutation</topic><topic>Patients</topic><topic>Potassium</topic><topic>Sodium</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ono, Ryohei</creatorcontrib><creatorcontrib>Hori, Yasuhiko</creatorcontrib><creatorcontrib>Yamazaki, Tatsuro</creatorcontrib><creatorcontrib>Takahashi, Hidehisa</creatorcontrib><creatorcontrib>Fukushima, Kenichi</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Proquest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Curēus (Palo Alto, CA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ono, Ryohei</au><au>Hori, Yasuhiko</au><au>Yamazaki, Tatsuro</au><au>Takahashi, Hidehisa</au><au>Fukushima, Kenichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cardiac Arrest Due to Brugada Syndrome Associated With Influenza Infection: A Case Report and Literature Review</atitle><jtitle>Curēus (Palo Alto, CA)</jtitle><addtitle>Cureus</addtitle><date>2023-04-05</date><risdate>2023</risdate><volume>15</volume><issue>4</issue><spage>e37158</spage><pages>e37158-</pages><issn>2168-8184</issn><eissn>2168-8184</eissn><abstract>A 38-year-old Japanese male with no significant medical history but a family history of sudden cardiac death was referred for cardiac arrest. He had a fever (40°C) one day before his visit. His wife reported that he groaned while unconscious, which prompted a referral to the authors' hospital. He was febrile and experienced ventricular fibrillation in the emergency department. After the resolution of ventricular fibrillation, electrocardiography revealed a right bundle branch block with ST-segment elevation in leads V1-3, consistent with a Brugada electrocardiographic pattern; he also tested positive for influenza A infection. Antiarrhythmic and antipyretic agents were administered, and peramivir was initiated; a fatal arrhythmia did not occur. A cardioverter-defibrillator was implanted, and the patient was discharged without complications. Brugada syndrome is a genetic disease that causes fatal cardiac arrhythmias, with fever recognized to induce the Brugada electrocardiographic pattern. The mechanism of the Brugada-type electrocardiographic pattern, right bundle branch block, and ST-segment elevation in the right precordial leads is considered to be the result of an outward shift of ionic currents during early repolarization, causing a marked abbreviation of the action potential in epicardial cells of the right ventricle. Activation and inactivation kinetics for early sodium currents are faster at higher temperatures. To date, there have only been four published reports describing Brugada-like electrocardiographic changes associated with fever related to influenza infection, and this is the first report of cardiac arrest. Since influenza infection can cause high fever and trigger the fetal arrhythmia of Brugada syndrome, it is important to shorten the duration of the fever. Anti-influenza therapy may be considered in patients who have a history of sudden cardiac arrest in the family, as influenza may influence the development of the Brugada ECG pattern in these individuals. The authors also review the literature on Brugada-like electrocardiographic changes induced by influenza infection. Physicians should be aware that Brugada's electrocardiographic pattern and cardiac arrest can be caused by febrile episodes, including those related to influenza infection.</abstract><cop>United States</cop><pub>Cureus Inc</pub><pmid>37168174</pmid><doi>10.7759/cureus.37158</doi><oa>free_for_read</oa></addata></record> |
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subjects | Analgesics Body temperature Cardiac arrest Cardiac arrhythmia Cardiology Case reports Consciousness Electrocardiography Electrolytes Emergency Medicine Enzymes Family medical history Fever Infections Infectious Disease Influenza Kinases Mutation Patients Potassium Sodium |
title | Cardiac Arrest Due to Brugada Syndrome Associated With Influenza Infection: A Case Report and Literature Review |
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