Drug-induced pericarditis mimicking Brugada syndrome

Europace. 2007 Jan;9(1):66-8. doi: 10.1093/europace/eul140.

Abstract

Brugada syndrome (BS) is associated with sudden cardiac death in patients with a structurally normal heart. The ECG pattern of BS has also been described in patients with myocardial abnormalities. Cardiac hypersensitivity and myopericarditis have been reported during long-term treatment with mesalazine. We report the case of a man, treated with mesalazine for Crohn's disease who developed drug-induced pericarditis. The ECG showed a coved ST-segment elevation in the right precordial leads V1-V3, a pattern mimicking BS. The ECG normalized in a few days after mesalazine withdrawal and the follow-up was uneventful. The ECG remained normal. Two ajmaline tests were both negative and ruled out the diagnosis of BS. This observation illustrates that a coved ST-segment elevation in the right precordial leads should not be, systematically, regarded as a marker of a specific syndrome, but may also reflect a common electrical manifestation of abnormalities in the right ventricle or pericardium.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Brugada Syndrome / diagnosis*
  • Brugada Syndrome / physiopathology
  • Crohn Disease / drug therapy
  • Diagnosis, Differential
  • Electrocardiography
  • Humans
  • Male
  • Mesalamine / adverse effects*
  • Mesalamine / therapeutic use
  • Pericarditis / chemically induced*
  • Pericarditis / diagnosis*
  • Pericarditis / physiopathology

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Mesalamine