Image in Cardiology
Fever in an elderly patient unmasks Brugada syndrome
Febre num idoso desmascara síndrome de Brugada
Sofia Lázaro Mendes
, Luís Elvas, Domingos Ramos, Mariano Pêgo
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Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
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array:24 [ "pii" => "S087025511730152X" "issn" => "08702551" "doi" => "10.1016/j.repc.2016.07.014" "estado" => "S300" "fechaPublicacion" => "2017-04-01" "aid" => "976" "copyright" => "Sociedade Portuguesa de Cardiologia" "copyrightAnyo" => "2017" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2017;36:317-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2167 "formatos" => array:3 [ "EPUB" => 183 "HTML" => 1508 "PDF" => 476 ] ] "itemSiguiente" => array:19 [ "pii" => "S0870255117301518" "issn" => "08702551" "doi" => "10.1016/j.repc.2016.04.019" "estado" => "S300" "fechaPublicacion" => "2017-04-01" "aid" => "975" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2017;36:319-20" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2338 "formatos" => array:3 [ "EPUB" => 155 "HTML" => 1750 "PDF" => 433 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Left-sided endocarditis extending to the right chambers: Usefulness of three-dimensional echocardiography in preoperative assessment" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "319" "paginaFinal" => "320" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Endocardite esquerda com extensão direita: utilidade da ecocardiografia tridimensional na avaliação pré-operatória" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1417 "Ancho" => 1882 "Tamanyo" => 191954 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Transesophageal echocardiography in mid-esophageal view: (A) two-dimensional transesophageal echocardiography (2D-TEE) showing a cavity between the aortic prosthesis and the right atrium RA corresponding to a PA, which communicates with the RA (blue arrow) and with the RV through the base of the TSL (yellow arrow); (B) three-dimensional transesophageal echocardiography (3D-TEE), showing the PA from the RA in the middle of the image, the aortic prosthesis on the left, the superior vena cava on the right, the interatrial septum at the top and the TSL at the bottom; (C) 2D-TEE showing turbulent flow from the PA to the RA and to the RV; (D) 3D-TEE image showing the same defects in more detail. PA: pseudoaneurysm; RA: right atrium; RV: right ventricle; TSL: tricuspid septal leaflet.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Zorba Blázquez Bermejo, Teresa López Fernández, Ulises Ramírez Valdiris, Juan Caro Codón, Inés Ponz de Antonio, Sandra Rosillo Rodríguez, José María Mesa García, Mar Moreno Yangüela" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Zorba" "apellidos" => "Blázquez Bermejo" ] 1 => array:2 [ "nombre" => "Teresa" "apellidos" => "López Fernández" ] 2 => array:2 [ "nombre" => "Ulises" "apellidos" => "Ramírez Valdiris" ] 3 => array:2 [ "nombre" => "Juan" "apellidos" => "Caro Codón" ] 4 => array:2 [ "nombre" => "Inés" "apellidos" => "Ponz de Antonio" ] 5 => array:2 [ "nombre" => "Sandra" "apellidos" => "Rosillo Rodríguez" ] 6 => array:2 [ "nombre" => "José María" "apellidos" => "Mesa García" ] 7 => array:2 [ "nombre" => "Mar" "apellidos" => "Moreno Yangüela" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117301518?idApp=UINPBA00004E" "url" => "/08702551/0000003600000004/v1_201704060057/S0870255117301518/v1_201704060057/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0870255117301567" "issn" => "08702551" "doi" => "10.1016/j.repc.2017.02.011" "estado" => "S300" "fechaPublicacion" => "2017-04-01" "aid" => "984" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2017;36:313-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2394 "formatos" => array:3 [ "EPUB" => 223 "HTML" => 1614 "PDF" => 557 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Ablation of stable complex fractionated atrial electrogram defined by dynamic overlaid mapping in persistent atrial fibrillation" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "313" "paginaFinal" => "316" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Mapas de sobreposição dinâmica na fibrilhação auricular persistente: ablação de um eletrograma complexo fracionado estável" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1875 "Ancho" => 2500 "Tamanyo" => 178717 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Posteroanterior view of the left atrium showing a stable complex fragmented atrial electrogram (CFAE) defined by dynamic overlaid mapping. Anatomy defined by the Ensite NavX™ system; electrograms recorded by basket catheter (Constellation, Boston Scientific); ablation performed by ablation catheter (yellow) located over the area of a stable CFAE (white arrow). CFAE: complex fractionated atrial electrogram; CS: coronary sinus; LIPV: left inferior pulmonary vein; LSPV: left superior pulmonary vein; RIPV: right inferior pulmonary vein; RSPV: right superior pulmonary vein.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pedro Adragão, Pedro Carmo, Diogo Cavaco, João Carmo, Francisco Costa, Francisco Morgado" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Pedro" "apellidos" => "Adragão" ] 1 => array:2 [ "nombre" => "Pedro" "apellidos" => "Carmo" ] 2 => array:2 [ "nombre" => "Diogo" "apellidos" => "Cavaco" ] 3 => array:2 [ "nombre" => "João" "apellidos" => "Carmo" ] 4 => array:2 [ "nombre" => "Francisco" "apellidos" => "Costa" ] 5 => array:2 [ "nombre" => "Francisco" "apellidos" => "Morgado" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117301567?idApp=UINPBA00004E" "url" => "/08702551/0000003600000004/v1_201704060057/S0870255117301567/v1_201704060057/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in Cardiology</span>" "titulo" => "Fever in an elderly patient unmasks Brugada syndrome" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "317" "paginaFinal" => "318" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Sofia Lázaro Mendes, Luís Elvas, Domingos Ramos, Mariano Pêgo" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Sofia Lázaro" "apellidos" => "Mendes" "email" => array:1 [ 0 => "sofialazaromendes@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Luís" "apellidos" => "Elvas" ] 2 => array:2 [ "nombre" => "Domingos" "apellidos" => "Ramos" ] 3 => array:2 [ "nombre" => "Mariano" "apellidos" => "Pêgo" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Febre num idoso desmascara síndrome de Brugada" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 667 "Ancho" => 2252 "Tamanyo" => 181135 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Electrocardiogram at admission showing coved ST-segment elevation in V1 and V2 followed by a negative T wave.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0195" class="elsevierStylePara elsevierViewall">A 74-year-old man was admitted to the emergency department after experiencing a syncopal episode followed by ventricular fibrillation witnessed by the medical emergency team. After defibrillation and one round of cardiopulmonary resuscitation, the patient regained spontaneous circulation. He had presented malaise and fever during the night. His blood pressure was 125/78 mmHg, his oxygen saturation was 96% on room air and his temperature was 38.2<span class="elsevierStyleHsp" style=""></span>°C. An electrocardiogram (ECG) at admission demonstrated a coved ST-segment elevation in V1 and V2 followed by a negative T wave, compatible with type 1 Brugada pattern (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>). There was no family history of sudden death or heart disease. His previous ECG, performed six months previously, was essentially normal (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>). The transthoracic echocardiogram excluded structural heart disease. Coronary angiography excluded coronary disease. He was admitted to the cardiac care unit for closer monitoring. Repeat ECG 24 hours later in apyrexia showed complete normalization. The infection was resolved and a cardioverter-defibrillator was implanted before discharge.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical disclosures</span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of human and animal subjects</span><p id="par0200" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Confidentiality of data</span><p id="par0205" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0210" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0190" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:3 [ "identificador" => "sec0085" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0090" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0095" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0100" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0080" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-03-19" "fechaAceptado" => "2016-07-26" "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 667 "Ancho" => 2252 "Tamanyo" => 181135 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Electrocardiogram at admission showing coved ST-segment elevation in V1 and V2 followed by a negative T wave.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 612 "Ancho" => 2250 "Tamanyo" => 123103 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Previous electrocardiogram performed six months previously (essentially normal).</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000003600000004/v1_201704060057/S087025511730152X/v1_201704060057/en/main.assets" "Apartado" => array:4 [ "identificador" => "29264" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Imagens em Cardiologia" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003600000004/v1_201704060057/S087025511730152X/v1_201704060057/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S087025511730152X?idApp=UINPBA00004E" ]
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