ECG in an Athlete With Syncope: Innocuous Incomplete Right Bundle Branch Block or Brugada Pattern?

Area of Science:

• Cardiology
• Sports Medicine
• Clinical Electrophysiology

Background:

• Electrocardiogram (ECG) abnormalities in athletes require careful evaluation to differentiate benign findings from potentially life-threatening cardiac conditions.
• Undiagnosed heart disease in athletes can lead to adverse events, including sudden cardiac death.
• Distinguishing between various electrocardiographic patterns is crucial for appropriate risk stratification.

Observation:

• A young marathon athlete presented with syncope, a symptom of fainting.
• The athlete exhibited an incomplete right bundle branch block pattern on their electrocardiogram.
• This pattern was suggestive of a type 2 Brugada pattern.

Findings:

• The case illustrates a diagnostic challenge in differentiating Brugada pattern from other right bundle branch block morphologies in athletes.
• Syncope in athletes can be a red flag for underlying cardiac electrical abnormalities.
• Type 2 Brugada pattern, though less common, carries significant implications for arrhythmogenic risk.

Implications:

• Accurate identification of Brugada pattern in athletes is vital for preventing sudden cardiac death.
• This case underscores the importance of comprehensive cardiac evaluation in athletes presenting with syncope and ECG abnormalities.
• Further research into ECG interpretation in athletic populations is warranted to refine diagnostic criteria and management strategies.