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Brugada syndrome presenting as an acute coronary syndrome

Ian Buysschaert1, Rudy De Rybel, Karl Dujardin

  • 1Department of Cardiology, Heilig Hartziekenhuis, Roeselare, Belgium.

Acta Cardiologica
|November 29, 2013
PubMed

Insights

Syncope with elevated troponin and normal coronary angiogram can mimic acute coronary syndrome. This case highlights Brugada syndrome as a critical diagnosis in such presentations.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Genetics

Background:

  • Syncope, ST-segment alterations, and elevated cardiac troponin (cTn) levels are key indicators for acute coronary syndrome (ACS).
  • A normal coronary angiogram typically excludes ACS, but elevated cTn necessitates investigation for alternative life-threatening conditions like pulmonary embolism, myocarditis, or ventricular arrhythmias.

Observation:

  • A 42-year-old male presented with syncope, ST-segment elevation, elevated cTn, and a normal coronary angiogram.
  • Initial diagnostic workup focused on ruling out acute coronary syndrome.

Findings:

  • Despite a normal coronary angiogram, the patient's presentation suggested a cardiac emergency.
  • The diagnostic process ultimately identified Brugada syndrome as the underlying cause.

Implications:

  • This case underscores the importance of considering Brugada syndrome in patients with syncope, ECG changes, and elevated troponin, even with normal coronary arteries.
  • Broadening the differential diagnosis beyond ACS is crucial for accurate and timely patient management.
  • Recognizing Brugada syndrome can prevent misdiagnosis and guide appropriate therapeutic strategies.

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