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Earliest electrocardiogram is golden for the diagnosis of Brugada syndrome

Omer Faruk Celik1, Haldun Akoglu, Serkan Eroglu

  • 1Marmara University Pendik Education and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey.

The American Journal of Emergency Medicine
|September 4, 2013
PubMed

Insights

Brugada syndrome, a cause of sudden cardiac death, presents with specific ECG changes. Early electrocardiograms (ECGs) are crucial for diagnosis, even if subsequent tests are normal.

Area of Science:

  • Cardiology
  • Clinical Electrophysiology

Background:

  • Cardiac syncope, a potential warning of sudden cardiac death, can stem from structural or dysrhythmogenic causes.
  • Brugada syndrome is a key cause of dysrhythmic sudden cardiac death in young adults with structurally normal hearts.

Observation:

  • A 23-year-old male presented with syncope, revealing a family history of premature sudden death.
  • Initial electrocardiogram (ECG) showed a transient type 2 repolarization variant, indicative of Brugada syndrome.
  • Subsequent ECGs normalized, highlighting the diagnostic challenge of intermittent Brugada syndrome patterns.

Findings:

  • The earliest ECG was pivotal in diagnosing Brugada syndrome, despite its transient nature.
  • The patient's ECG pattern reverted to normal shortly after the initial presentation.
  • No further diagnostic ECG abnormalities were observed during follow-up.

Implications:

  • Emphasizes the critical importance of retaining and meticulously reviewing initial ECGs in syncope evaluations.
  • Highlights the diagnostic value of early ECGs for identifying conditions like Brugada syndrome, even with transient findings.
  • Suggests the need for physician expertise in interpreting subtle or evolving ECG patterns for accurate syncope diagnosis.

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