PMC6398420_01
There is the characteristic ST-segment elevation >=2 mm in >=1 right precordial lead (V1 to V3), followed by an r'-wave and a straight ST-segment.. Notes: Additionally, the descending ST-segment crosses the isoelectric line and is followed by a negative and symmetric T-wave. At 40 ms of high takeoff, the decrease in amplitude of ST is <=4 mm, the duration of QRS is longer than in a right bundle branch block and there is a mismatch between V1 and V6 (Figure 2). No high-pass filters were applied to attenuate low-frequency noise.
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On admission, the patient's ECG displayed a coved ST-segment elevation in V1 and V2, with elevated J points suggestive of a Brugada type 1 pattern (Figure 1).
(A) Admission ECG upon presentation indicating a coved ST-segment elevation (black arrows) in V1 and V2, with elevated J points suggestive of a Brugada type 1 pattern. The patient's serum sodium was 108 mg/dL (normal 135-145 mg/dL). (B) Day 5 ECG indicating resolution of the Brugada type 1 pattern (black arrows) with normalization of serum sodium. The patient's serum sodium was 135 mg/dL (normal 135-145 mg/dL).. Abbreviation: ECG, electrocardiogram.
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Gradually, his electrolyte derangements (hyponatremia and hyposmolality) resolved over the ensuing hospitalization and serial daily ECGs revealed subsequent normalization of the ECG abnormalities (Figure 2).