safety · 2025-11-11
Kratom Overdose Triggers Brugada Phenocopy Cardiac Pattern
Source: Academic Research
Why it matters
A kratom overdose caused a dangerous Brugada-like ECG pattern in a patient that fully resolved within 24 hours — a critical warning for clinicians seeing patients who use kratom for medical self-management.
The big picture
As kratom use grows globally, clinicians need to recognize that it can mimic serious cardiac conditions. Brugada phenocopies induced by kratom are reversible, but they require careful monitoring and highlight the risks of unregulated, high-dose kratom use.
Key findings
- • A 54-year-old man who took ~10x his usual kratom dose developed coved ST elevation consistent with a Type I Brugada pattern
- • The abnormal ECG fully resolved with supportive care within 24 hours in the ICU
- • A procainamide challenge was negative, confirming this was a Brugada phenocopy (environmental, not genetic cardiac channelopathy)
- • Mitragynine inhibits delayed rectifier potassium currents, potentially prolonging action potential duration and QT interval
- • The patient remained arrhythmia-free for over 1 year after stopping kratom
Bottom line
Single case report from Sunnybrook Health Sciences Centre, University of Toronto; published in CJC Open (2025).