Case Report

Brugada Syndrome Mimicking Acute Coronary Syndrome

Authors: Samir Edward Yousef, MD, John M. Herre, MD, FACC

Abstract

This report describes a 42-year-old man with Brugada syndrome (BRS) mimicking acute coronary syndrome. Chest pain, near-syncope, and electrocardiographic changes were thought initially to be due to ischemia. Cardiac catheterization was performed. The coronary arteries and left ventricular function were normal. Careful review of his electrocardiogram suggested a diagnosis of BRS. BRS may be confused with acute coronary syndrome; early recognition of this syndrome is essential, as implantable cardioverter-defibrillator therapy may be life-saving.


Key Points


* Brugada syndrome (BRS) is a primary cardiac electrophysiologic disease of the right ventricular epicardium.


* BRS should be considered as a differential diagnosis in patients with unexplained syncope or sudden cardiac death.


* BRS should be considered in the differential diagnosis of ST-segment elevation in the right precordial leads not explainable by other conditions such as ischemia, electrolyte abnormality, or structural heart disease.


* The only effective gold standard therapy to date is an implantable cardiac defibrillator, which should be considered in symptomatic individuals and in asymptomatic patients with positive electrophysiologic testing.

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