Propranolol intoxication revealing a Brugada syndrome

J Cardiovasc Electrophysiol. 2005 Mar;16(3):348-51. doi: 10.1046/j.1540-8167.2005.40564.x.

Abstract

This is the first report of Brugada syndrome revealed by beta-blocker intoxication. A 24-year-old healthy man ingested propranolol (2.28 g) to commit suicide. After early gastric lavage, electrolytes, cardiac enzymes, chest X-ray, and echocardiography were normal. Dosages of psychotropic drugs were negative. ECG showed a typical coved-type pattern of Brugada syndrome. Follow-up showed partial ECG normalization of the discrete saddleback-type pattern. The ajmaline- test confirmed Brugada syndrome. These ECG modifications may be explained by the stabilizing membrane effect of high concentration of propranolol and/or inhibition of ICaL. This case illustrates the possible deleterious effects of beta-blockers in patients with Brugada syndrome.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic beta-Antagonists / toxicity*
  • Adult
  • Atropine / therapeutic use
  • Bundle-Branch Block / chemically induced*
  • Bundle-Branch Block / diagnosis
  • Bundle-Branch Block / physiopathology
  • Death, Sudden, Cardiac / etiology*
  • Electrocardiography
  • Glucagon / therapeutic use
  • Humans
  • Male
  • Propranolol / toxicity*
  • Suicide, Attempted
  • Syndrome
  • Ventricular Fibrillation / chemically induced*
  • Ventricular Fibrillation / physiopathology

Substances

  • Adrenergic beta-Antagonists
  • Atropine
  • Glucagon
  • Propranolol