Abstract
Introduction. Brugada syndrome accounts for about 4% of sudden cardiac deaths (SCD). It is characterized by an ST-segment elevation in the right precordial electrocardiogram (EKG) leads. Case Presentation. We describe a 39-year-old healthy Caucasian man who was admitted to the intensive care unit after being cardioverted from ventricular fibrillation (VF) arrest. His past history was significant for an episode of syncope one month prior to this presentation for which he was admitted to an outlying hospital. EKG during that admission showed ST elevations in V1 and V2 leads, a pattern similar to Type 1 Brugada. A diagnosis of Brugada syndrome was missed and the patient had a cardiac arrest a month later. We discuss a short review of Brugada syndrome and emphasize the need to look for it in patients presenting with SCD and malignant arrhythmias. Conclusion. Physicians should always consider Brugada syndrome in the differential diagnosis of ST-segment elevation in anterior precordial leads of EKG and associated VT/VF. Although more than 17 years have passed since the first case was reported, increased awareness of this syndrome is needed to identify patients with EKG changes and treat them accordingly to prevent incidence of (SCD) and its deleterious complications.
Highlights
Brugada syndrome accounts for about 4% of sudden cardiac deaths (SCD)
It is more common in males than females and typically first presents in the third decade of life, it has been reported in children and the elderly too [2]
We present a case whose diagnosis is missed in the early presentation and developed SCD and its sequelae
Summary
Brugada syndrome is a clinical entity first described in 1992 [1]. It is an autosomal dominant genetically predisposed disorder, characterized by an ST-segment elevation in the right precordial EKG leads and a high incidence of sudden cardiac death (SCD) in patients with structurally normal hearts. Almost 4% of patients presenting with SCD have Brugada syndrome, and it should be looked for in patients with SCD. It is more common in males than females and typically first presents in the third decade of life, it has been reported in children and the elderly too [2]. We present a case whose diagnosis is missed in the early presentation and developed SCD and its sequelae
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