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BRUGADA PATTERN IN HEROIN ADDICTION: SYNDROME OR PHENOCOPY?
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  • Ettore Mancia,
  • Gregory Dendramis,
  • Caterina Carollo,
  • Laura Guarino,
  • Marco Guarneri,
  • Leonardo Calandra,
  • Santina Cottone,
  • Giuseppe Mulè
Ettore Mancia
Università degli Studi di Palermo
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Gregory Dendramis
Ospedale Civico Palermo
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Caterina Carollo
Università degli Studi di Palermo
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Laura Guarino
Università degli Studi di Palermo
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Marco Guarneri
Università degli Studi di Palermo
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Leonardo Calandra
Università degli Studi di Palermo
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Santina Cottone
Università degli Studi di Palermo
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Giuseppe Mulè
Università degli Studi di Palermo
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Abstract

Introduction: Brugada phenocopies (BrPs) are clinical entities that differ in etiology from true congenital Brugada syndrome (BrS) but have identical electrocardiographic (ECG) patterns. Methods: Our Manuscript reports a interesting case of BrP in a young man with heroin overdose who developed Acute Kidney Failure secondary to rhabdomyolysis. His initial ECG showed Brugada type 1 pattern with elevation “Coved-Type” of the ST segment in V1 and V2. The Brugada ECG pattern resolved upon hemodialysis treatment. Provocative testing using sodium channel blockers was performed, and failed to reproduce a BrS ECG pattern, confirming the diagnosis of Brugada’s phenocopy. Conclusion: Several clinical conditions can imitate a true Brugada Syndrome and Brugada Phenocopies are a part of those conditions. A systematic approach and a prompt recognition of this clinical and electrocardiographic entity may avoid diagnostic errors and may promote the initiation of appropriate treatments.