Transient Brugada phenocopy during evolving ischemic right bundle branch block

Abstract

A “Brugada phenocopy” (BrP) is a clinical presentation exhibiting the same electrocardiographic characteristics of true Brugada syndrome (BrS) in different clinical scenarios. We report the clinical case of a 59-year-old male patient with acute chest pain depicting BrP followed by extensive convex ST-segment elevation due to proximal thrombosis of the left descending coronary artery. Following successful percutaneous intervention and drug-eluting stent implantation, a classical right bundle branch block pattern emerged.  We discussed possible mechanism and clinical implications of this unusual electrical sequence during acute myocardial injury.