Brugada Syndrome
Background
Patients with Brugada syndrome may present with VT (syncope or cardiac arrest)
- Anatomically abnormal right ventricular outflow tract
- Aurosomal dominant Na+ channelopathy
- Particularly prevalent in 30-50 yo, Asian men
- Increased vagal tone (particularly post exercise) may precipitate arrhythmia
- Exertional (or immediately post exertional) syncope is always pathological
- ECG findings may ony be seen after flecanaide, procainamide or a Β-blocker
ECG
- ECG changes may be intermittant and transient
- Unusual or saddle-shaped ST elevation in leads V1 - V3
- Partial or complete RBBB (+ T inversion)
- J point elevation
Treatment
- Check for electrolyte abnormalities (particularly K+, Ca++ and Mg++)
- Refer cardiology to confirm syndrome (and advise on competative sport etc)
- Implantable defibrillator!
References
