CARDIOLOGY
BRUGADA SYNDROME
PromptECG - Describe changes you would expect in Brugada syndrome
ResponseST elevation >/=2mm followed by negative T wave in V1-2 or coved ST elevation >2mm in V1-2; in association with syncope, this is diagnostic of Brugada syndrome
PromptECG - Interpret
Response
PromptDDx of brugada looking ECG’
ResponseAtypical RBBB
Myocardial ischaemia/infarction
Benign Early Repolarisation
PE
Myo/pericarditis
Athletes
Pectus excavatum
RV outflow obstruction or other RV abnormality
Myocardial ischaemia/infarction
Benign Early Repolarisation
PE
Myo/pericarditis
Athletes
Pectus excavatum
RV outflow obstruction or other RV abnormality
PromptImportant Brugada history questions
ResponseFamily history of sudden cardiac death < 45 years of age
Triggers such as any fever? Drugs? eg Na ch blocker, CCB, BB, nitrates, alpha agonist,
cocaine, alcohol
Exertion related
Nocturnal agonal respirations
Others
Triggers such as any fever? Drugs? eg Na ch blocker, CCB, BB, nitrates, alpha agonist,
cocaine, alcohol
Exertion related
Nocturnal agonal respirations
Others
PromptManagement
ResponseAdmit for monitoring – explain concern for serious dysrhythmia
Cardiology referral and regular follow up will be required; consideration for ICD
Family screening is strongly recommended in first-degree relatives (autosomal dominant inherited disease); genetic counselling/testing if available (but low diagnostic yield)
Avoid drugs/triggers eg as mentioned above
Cardiology referral and regular follow up will be required; consideration for ICD
Family screening is strongly recommended in first-degree relatives (autosomal dominant inherited disease); genetic counselling/testing if available (but low diagnostic yield)
Avoid drugs/triggers eg as mentioned above