A Brugada-Pattern Electrocardiogram and Thyrotoxic Periodic Paralysis
Authors: Chin-Feng Tsai, Der-Jinn Wu, Ming-Cheng Lin, Kwo-Chang Ueng, Chung-Sheng Lin
Journal: Annals of Internal Medicine (2010)

Letters21 December 2010A Brugada-Pattern Electrocardiogram and Thyrotoxic Periodic ParalysisChin-Feng Tsai, MD, Der-Jinn Wu, MD, PhD, Ming-Cheng Lin, MD, PhD, Kwo-Chang Ueng, MD, PhD, and Chung-Sheng Lin, MD, PhDChin-Feng Tsai, MDFrom School of Medicine, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China., Der-Jinn Wu, MD, PhDFrom School of Medicine, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China., Ming-Cheng Lin, MD, PhDFrom School of Medicine, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China., Kwo-Chang Ueng, MD, PhDFrom School of Medicine, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China., and Chung-Sheng Lin, MD, PhDFrom School of Medicine, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-12-201012210-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: The Brugada syndrome is an inherited arrhythmogenic disease characterized by distinct coved-type ST-segment elevation in the right precordial leads with susceptibility to life-threatening ventricular arrhythmias. Several medications and disease states may induce a Brugada-pattern electrocardiogram (ECG) in some patients, but whether these patients are at risk for ventricular arrhythmias is uncertain (1).Objective: To describe a patient with thyrotoxic periodic paralysis who had a Brugada-pattern ECG without evidence of genetically determined Brugada syndrome.Case Report: An otherwise healthy 51-year-old man presented to our emergency department in January 2005 with sudden onset of bilateral leg weakness hours after having a ...References1. Antzelevitch C, Brugada P, Borggrefe M, Brugada J, Brugada R, Corrado D, et al. Brugada syndrome: report of the second consensus conference: endorsed by the Heart Rhythm Society and the European Heart Rhythm Association. Circulation. 2005;111:659-70. CrossrefMedlineGoogle Scholar2. Chan A, Shinde R, Chow CC, Cockram CS, Swaminathan R. In vivo and in vitro sodium pump activity in subjects with thyrotoxic periodic paralysis. BMJ. 1991;303:1096-9. CrossrefMedlineGoogle Scholar3. Lee KO, Taylor EA, Oh VM, Cheah JS, Aw SE. Hyperinsulinaemia in thyrotoxic hypokalaemic periodic paralysis. Lancet. 1991;337:1063-4. CrossrefMedlineGoogle Scholar4. Nishizaki M, Sakurada H, Ashikaga T, Yamawake N, Fujii H, Arita M, et al. Effects of glucose-induced insulin secretion on ST segment elevation in the Brugada syndrome. J Cardiovasc Electrophysiol. 2003;14:243-9. CrossrefMedlineGoogle Scholar5. Hedley PL, Jørgensen P, Schlamowitz S, Moolman-Smook J, Kanters JK, Corfield VA, et al. The genetic basis of Brugada syndrome: a mutation update. Hum Mutat. 2009;30:1256-66. CrossrefMedlineGoogle Scholar6. Kung AW, Lau KS, Fong GC, Chan V. Association of novel single nucleotide polymorphisms in the calcium channel alpha 1 subunit gene (Ca(v)1.1) and thyrotoxic periodic paralysis. J Clin Endocrinol Metab. 2004;89:1340-5. CrossrefMedlineGoogle Scholar7. Hoogendijk MG, Opthof T, Postema PG, Wilde AA, de Bakker JM, Coronel R. The Brugada ECG pattern: a marker of channelopathy, structural heart disease, or neither? Toward a unifying mechanism of the Brugada syndrome. Circ Arrhythm Electrophysiol. 2010;3:283-90. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From School of Medicine, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China.Grant Support: In part by the National Science Council (NSC-99-2314-B-040-017), Taiwan, Republic of China.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHyperthyroidism precipitating cardiac arrest in a patient with Brugada patternThe 10-Year Prognosis and Prevalence of Brugada-Type Electrocardiograms in Elderly WomenBrugada Phenocopy: New Terminology and Proposed Classification 21 December 2010Volume 153, Issue 12Page: 848-849KeywordsElectrocardiographyGlucoseHyperglycemiaInsulinLaboratory testsMusclesParalysisPotassiumThyroid-stimulating hormoneThyroxine ePublished: 21 December 2010 Issue Published: 21 December 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...