Introduction: The Brugada syndrome is a rare genetic disease that can lead to death. Its diagnosis requires electrocardiography.
Case: A 36-year-old man was admitted with syncope. Brugada syndrome was diagnosed by the typical ECG pattern. The interaction between lithium therapy and ECG was shown clearly by the alternating type 1 and type 3 Brugada ECG patterns, depending on lithium status.
Discussion: The Brugada syndrome may be unmasked by lithium therapy, due to its properties as a Na+ channel blocker, even at low doses. This case also demonstrated the usefulness of ECG in detecting the Brugada syndrome before and during lithium prescription.