Brugada electrocardiographic pattern induced by fever
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Introduction:
Brugada syndrome (BS) is a channelopathy that may be familial or sporadic and is a major cause of sudden death in young men with no evidence of structural heart disease. The electrocardiogram (ECG) is characterized by persistent ST segment elevation in the right precordial leads unrelated to ischemia, right bundle branch block and rapid polymorphic ventricular tachycardia capable of degenerating into ventricular fibrillation. The ECG pattern may be dynamic and is often concealed. Sodium channel blockers, tricyclic antidepressants, anesthetics, cocaine, methadone, antihistamines, electrolyte imbalances and fever are recognized inducers. Here we present 2 patients with Brugada-type ECG induced by fever, and review the current literature.

Case
A 48-year-old male, renal transplant recipient was admitted to our hospital because of pneumonia. He denied a history of syncope or palpitations and his family history was negative for sudden death. On physical examination, his temperature was 39?°C and his heart rate was 120 beats/min. A cardiac examination was unremarkable. Because of atypical chest pain on admission, an ECG was performed that revealed sinus tachycardia and saddleback ST segment elevation in V1 and V2. Initial laboratory data showed an increased creatinine level (1.9 mg/dL; normal range, 0.5-1.5 mg/dL) and normal potassium level (4.2 mEq/L). Troponin, creatine kinase (CK) and CK-MB were negative. An echocardiogram showed normal systolic function and absence of segmental abnormalities. ECG findings resolved when the patient became afebrile even though sinus tachycardia persisted. One year after discharge, the patient remained alive with no episodes of syncope....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312236/
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