Brugada Syndrome

 

• it's channelopathy disorder in the form of reduce sodium current
• inherited in the form of Autosomal dominant, typically in young, male, and othewise healthy normal
• it's a cause of polymorphic ventricular tachycardia which can develop to ventricular fibrillation leading to sudden death
• syncope and cardiac arrest are the most common clinical presentations
• nightmares may be found
• may subtle abnormality in right ventricle reported
• if you suspect Brugada syndrome do :- 

             * 12-lead ECG in all patient 
             * Drug challengewith sodium channel blocker if syncope with                          obvious cause

             * Electrophysiologic study

             * Serum K, Ca, CK-MB

             * Genetic test for mutation in SCN5A

Feature on ECG :- 

• incomplete RBBB
• ST elevation in anterior leads

three types of Brugada

• Type 1 .... pronounced elevation of j point ( coved st ) and inverted t wave 
• Type 2 .... saddleback st elevated by more than 1mm
• Type 3 .... st elevated less than 1mm

Treatment :- 

the only treatment is implantable cardioversion defibrillator  ICD.