I read a story yesterday in the news about a Columbus man who collapsed during the Columbus half-marathon. He was taken to Grant Hospital in full arrest. He was successfully resuscitated and is, according to the news story, still alive. When they did his EKG they discovered he had Brugada Syndrome. I thought it might be useful to review a few important details about Brugada Syndrome in this week’s “in the news.”
1. It is one of the most common causes of sudden cardiac death. The fatal rhythm is ventricular fibrillation.
2. There are three commonly recognized forms of Brugada:
As you can see, in type 1, the changes are very obvious (RBBB pattern with ST elevation in V1-3.) The changes are more subtle in type 2 and 3. Type 2 has a saddle back pattern with a least 2 mm J-point elevation and at least 1 mm ST elevation with a positive or biphasic T-wave.Type 3 has a saddle back pattern with less than 2 mm J-point elevation and less than 1 mm ST elevation with a positive T-wave.
3. The disorder arises from a mutation in the sodium channel.
4. These patients are treated with an AICD (defibrillator).
5. When we order an EKG on someone (especially a young patient) in the ED after syncope, this is one of the major conditions we are looking for.