Brugada syndrome during physical therapy: a case report

Abstract

This case report describes about a young, male patient with persisting syncope during physical therapy for complex regional pain syndrome type 1 after metatarsal fractures.The patient was referred to the Emergency Department, where Brugada syndrome was diagnosed. A cardioverter defibrillator was prophylactically implanted successfully. After this procedure, there were no contraindications for resuming further physical therapy for his painful foot. No clear causal inference with Brugada could be drawn from the complex regional pain syndrome type 1 or physical therapy described in this case report. Hyperthermia may, however, occur during such therapy, which is associated with dysrhythmia in general.

Figures

Figure 1

Electrocardiography at first presentation. Electrocardiography at first presentation with a high take-off ST segment elevation with upward concavity and positive or biphasic T-wave resulting in a saddleback configuration.

Figure 2

Electrocardiography after provocation with flecainide. Electrocardiography after provocation with flecainide with a shift from type II to type I.

Figure 3

Electrophysiologic study shows ventricular flutter. Electrophysiologic study shows ventricular flutter after pacing the right ventricle with 500 min-1.