Brugada syndrome: Difference between revisions
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*ECG shows incomplete [[RBBB]] with [[ST elevation]] in V1-V3 | *ECG shows incomplete [[RBBB]] with [[ST elevation]] in V1-V3 | ||
== ECG Criteria == | ==Diagnosis== | ||
=== ECG Criteria === | |||
*Note - ECG findings can be transient | *Note - ECG findings can be transient | ||
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[[File:Brugada.jpg]]<br> | [[File:Brugada.jpg]]<br> | ||
==Differential Diagnosis== | |||
{{ST elevation DDX}} | |||
==Management== | |||
== Disposition == | == Disposition == | ||
*Pt requires admission for AICD placement. | *Pt requires admission for AICD placement. | ||
==See Also== | ==See Also== | ||
*[[ST elevation]] | |||
*[[ST | |||
== Source == | == Source == | ||
Revision as of 04:04, 28 December 2014
Background
- Consider as cause of syncope in pts w/ family history of sudden death
- Genetically-linked Na-channelopathy that increases the risk of sudden cardiac death (~10%/yr)[1]
- Much more common in men (up to 9x)
- ECG shows incomplete RBBB with ST elevation in V1-V3
Diagnosis
ECG Criteria
- Note - ECG findings can be transient
- Type 1-Elevated ST segment (>2mm) descends w/ upward convexity to a TWI
- Type 2-Elevated ST segment (>1mm) descends toward baseline then rises again (saddleback) to upright T wave
- Type 3-Elevated ST segment (<1mm) descends toward baseline then rises again to upright T wave
Differential Diagnosis
ST Elevation
- Cardiac
- ST-segment elevation myocardial infarction (STEMI)
- Post-MI (ventricular aneurysm pattern)
- Previous MI with recurrent ischemia in same area
- Wellens' syndrome
- Coronary artery vasospasm (eg, Prinzmetal's angina)
- Coronary artery dissection
- Pericarditis
- Myocarditis
- Aortic dissection in to coronary
- Left ventricular aneurysm
- Left ventricular pseudoaneurysm
- Early repolarization
- Left bundle branch block
- Left ventricular hypertrophy (LVH)
- Myocardial tumor
- Myocardial trauma
- RV pacing (appears as Left bundle branch block)
- Brugada syndrome
- Takotsubo cardiomyopathy
- AVR ST elevation
- Other thoracic
- Metabolic
- Drugs of abuse (eg, cocaine, crack, meth)
- Hyperkalemia (only leads V1 and V2)
- Hypothermia ("Osborn J waves")
- Medications
Management
Disposition
- Pt requires admission for AICD placement.
See Also
Source
- ↑ Cerrato N, Giustetto C, et al. Prevalence of Type 1 Brugada Electrocardiographic Pattern Evaluated by Twelve-Lead Twenty-Four-Hour Holter Monitoring. The American Journal of Cardiology.115(1). 2015. 52-56.