Brugada-like electrocardiographic changes induced by hypokalemia.

Since its description in 1992, Brugada Syndrome has become the second cause of death among young adults in some countries1. The Brugada syndrome is an autosomal dominant disease with incomplete penetrance, which may cause syncope and sudden cardiac death in young individuals with a normal heart. It is characterized by an electrocardiographic (ECG) pattern of complete or incomplete right bundle branch block (RBBB) and ST-segment elevation in leads V1-V3. The characteristic ECG findings are seen in some patients not affected by the syndrome2. Several nongenetic factors have been mentioned in the literature as possible inductors of the Brugada ECG pattern3. It may be induced in some patients during febrile states, electrolytes abnormalities, cocaine use and drugs that have a sodium channel-blocking effect, such as antiarrhythmics, anesthetics, and tricyclic antidepressants, among others4. We describe a case of a 21-year-old man who presented with severe hypokalemia and dynamic electrocardiographic changes compatible with Brugada pattern5.