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Brugada sign unmasking the location of an acute myocardial infarction

Eftychios Siniorakis1, Spyridon Arvanitakis, Eftychios Prokovas

  • 1Department of Cardiology, Sotiria Chest Diseases Hospital, Athens, Greece.

Kardiologia Polska
|September 1, 2010
PubMed

Insights

Brugada sign (BRSG) was unmasked in two acute myocardial infarction patients with initially unremarkable ECGs. This revealed lateral wall ischemia, correlating with coronary angiogram findings, aiding diagnosis.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Diagnostic Imaging

Background:

  • Acute myocardial infarction (AMI) diagnosis relies heavily on electrocardiograms (ECGs).
  • Subtle ECG findings can be missed, delaying diagnosis and treatment.
  • Brugada sign (BRSG) is a specific ECG pattern associated with cardiac channelopathies.

Observation:

  • Two patients with AMI presented with non-diagnostic ECGs.
  • Retrospective ECG review raised suspicion for Brugada sign (BRSG).
  • Sodium channel blocker administration unmasked the BRSG.

Findings:

  • Unmasked BRSG was unexpectedly associated with repolarization abnormalities.
  • These abnormalities indicated lateral wall ischemia.
  • The ischemic location correlated with coronary angiogram findings of culprit vessels.

Implications:

  • BRSG unmasking can aid in diagnosing AMI, especially with subtle ECGs.
  • This diagnostic approach may improve localization of myocardial damage.
  • Early identification of BRSG and ischemia can guide timely intervention.

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