Chest pain and ST elevation associated with fever in patients with asymptomatic Brugada syndrome: Fever and chest pain in Brugada syndrome

Brugada syndrome is a disease with a high risk of sudden cardiac death. Genetic mutations of the cardiac sodium channel are linked to the characteristic electrocardiogram abnormality of Brugada syndrome. Dysfunction of the mutated sodium channel is reported to be temperature-sensitive. We experienced two patients with asymptomatic Brugada syndrome who showed significant ST elevation in precordial leads while they were in a febrile state. Moreover, these patients had chest pain during precordial ST elevation. From these cases, asymptomatic Brugada syndrome should be considered as one of differential diagnoses when we examine the patients who complained of fever and chest pain. Furthermore, we should lower the elevated body temperature in patients with Brugada syndrome, because fever caused spontaneous ST elevation leading to fatal ventricular arrhythmias.