ISSN 1941-5923


Welcome to the American Journal of Case Reports

Clinical case reports are an invaluable first-hand source of evidence in medicine and a tool most often used in practice to exchange information and generate a more expanded search for evidence. In addition to the “evidence of what happened”, single or multiple cases are an important basis for further and more advanced research on diagnosis,  treatment effectiveness, causes and outcomes of disease. However limited their... read more

Published: 2014-12-16

Massive Electrical Storm at Disease Onset in a Patient with Brugada Syndrome

Jannik L. Pallisgaard, Uffe Gang, Jørgen K. Kanters, Peter R. Hansen

(Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark)

Am J Case Rep 2014; 15:559-561

DOI: 10.12659/AJCR.892314

Background: Brugada syndrome (BrS) is a genetic arrhythmogenic disease characterized by ST-segment elevations in the right precordial leads of the electrocardiogram (ECG). These ECG changes may be concealed and BrS may present with electrical storm characterized by recurrent ventricular tachycardia and fibrillation.
Case Report: A 49-year-old previously healthy man was admitted with electrical storm. The patient received direct current (DC) cardioversion shocks and only after intravenous lidocaine did the electrical storm slowly subside with a total of 255 DC shocks administered during the first 24 h after admission. He fully recovered and received an implantable cardioverter-defibrillator. Subsequent drug challenge with flecainide revealed type 1 BrS.
Conclusions: Massive electrical storm can be the first symptom of BrS and the diagnostic ECG changes may be concealed at presentation. Although hundreds of DC shocks may be required during initial treatment, full recovery can be achieved.

Keywords: Brugada syndrome, Defibrillators, Tachycardia, Ventricular

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