ELECTROPHYSIOLOGY
Drug-induced pericarditis mimicking Brugada syndrome
Cardiology Department, Amiens-Picardie University Hospital, Service de Cardiologie A, Groupe Hospitalier Sud, Avenue René Laënnec, 80054 Amiens Cedex 1, France
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.
Key Words: Brugada syndrome, Mesalazine, ST-segment elevation, Pericarditis
* Corresponding author. Tel: +33 3 22 45 58 75; fax: +33 3 22 45 56 61. E-mail address: hermida.jean-sylvain{at}chu-amiens.fr