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Brugada pattern after fever — SCE Acute Medicine MCQ

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HardAcute Cardiac PresentationsBrugada pattern after feverSCE Acute Medicine

A 38-year-old man is assessed on the acute medical unit. He attends with fever and syncope. ECG shows coved ST elevation in V1-V2 with T-wave inversion, and troponin is normal. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: D — Brugada syndrome unmasked by fever

Brugada syndrome unmasked by fever is the best answer because fever can unmask a type 1 Brugada ECG pattern in a patient with syncope. Acute pancreatitis is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Treat fever aggressively and seek electrophysiology advice.

Reference: ESC ventricular arrhythmia guideline