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Turner Syndrome Cardiac Screening — EECC MCQ

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HardCongenital Heart Disease (Adult)Turner Syndrome Cardiac ScreeningEECC

During potassium 7.2 mmol/L, a patient develops coved ST elevation in V1–V2 resembling a type-1 Brugada pattern. The tracing normalises completely after potassium correction; high right-precordial leads and ajmaline challenge are subsequently negative, with no personal or family arrhythmic history. How should the original ECG be classified?

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Correct answer: A — Classify this as a Brugada phenocopy caused by reversible hyperkalaemia

A Brugada phenocopy is a Brugada-like ECG caused by an identifiable reversible condition that disappears after correction, without evidence supporting the inherited syndrome. Persistent or drug-provoked type-1 morphology would support Brugada syndrome, but both are absent. Early repolarisation has a different lead distribution and risk framework, while arrhythmogenic cardiomyopathy cannot be diagnosed from a transient metabolic ECG pattern.

Reference: 2022 ESC Guidelines for ventricular arrhythmias and sudden cardiac death. https://academic.oup.com/eurheartj/article/43/40/3997/6675633