Brugada electrocardiographic pattern in a postoperative patient

Objective: To report the development of the Brugada electrocardiographic (ECG) pattern in the immediate postoperative setting. Design: Case report. Setting: Postanesthesia care unit at Memorial Sloan-Kettering Cancer Center. Patient A 51-yr-old white male who developed new ST-segment elevation in leads V₁-V₃ typical of the ECG changes of the Brugada syndrome immediately after undergoing head and neck surgery for cancer. The patient was asymptomatic, and the cardiac enzymes and echocardiogram were normal; therefore, electrophysiologic study was not performed. Conclusions: We postulated that the Brugada ECG abnormalities were induced primarily by an increase in parasympathetic tone resulting from vagal nerve manipulation during deep neck dissection and partially by the fever he developed during the postoperative period. In addition to the more common causes of ST-segment elevation, the Brugada ECG pattern or syndrome should be considered in patients undergoing deep neck dissection who develop characteristic ECG changes in association with normal cardiac enzymes and echocardiogram.