European Journal of Cardiovascular Medicine

'Brugada phenotype' on electrocardiogram (ECG) secondary to hyperkalemia is a known entity. However, 'Brugada phenotype' has rarely been documented secondary to tramadol usage and rhabdomyolysis. We present the case of a 25-years-old male doctor who was brought to the emergency room in a state of unconsciousness. His blood investigations showed acute kidney injury with elevated creatinine and urea. The former roommate found five used tramadol ampules, a bottle of normal saline, and intravenous (IV) sets in his room which gives the possibility of self• medication. The 'Brugada phenotype' appeared on ECG following 'Tramadol overdosage' and 'Exertional Rhabdomyolysis'. This ECG phenotype might very well be confused with ST-segment elevation myocardial infarction on ECG. After a dose of naloxone 1 mg IV, his ECG showed resolution of ST elevation in V1-V2 and he was managed medically along with daily haemodialysis. Brugada phenotype on ECG is a precursor for life-threatening arrhythmias.