Heart & Circulatory Health

Brugada Syndrome - the Silent Night Killer

Written by Dr. Isaac Gana and medically reviewed by iCliniq medical review team.

 
Image: Brugada Syndrome - the Silent Night Killer

In 1992, two brothers, namely Joseph and Pedro Brugada discovered this disease. It was causing sudden death by ventricular fibrillation. This disease was more prevalent in people of Asian origin than the American and European population, of which type 2 and 3 ECG patterns are most common. The average age of patients that die from this disease are around 35 to 40 years. This disease is a conduction disorder, characterized by incomplete right bundle branch block, and a coved-type ST elevation of more than 2 mm in leads V1 to V3. In the Philippines, it is known as "to rise and moan sleep."

Signs and Symptoms:

  • Cardiac arrest and syncope, which occurs mostly in the time of rest or sleep.
  • ST elevation in leads V1 to V3, which is mostly noticeable during a routine.
  • Fever is often the trigger.

Causes:

  • Brugada syndrome is mainly caused by genetic mutation of a gene known as SCN5A. It is the gene that encodes sodium ion channel in the cell membrane of heart muscles. Only about 20 % of patients with this disease have a mutation in this gene. It is more common in men than in women.

Diagnosis:

  • ECG (Electrocardiography): ECG shows a coved-type ST elevation in leads V1 to V3.
  • Genetic Testing: People with family history of sudden death should be genetically tested for a mutation in SCN5A.
  • Lab Test: Check for serum potassium and calcium levels in patients with ST elevation, as an increase in both potassium and calcium can generate ECG patterns similar to that of Brugada syndrome.

Treatment:

  • The most effective treatment at this moment is by implanting an automatic implantable cardioverter defibrillator. Medications are not effective.

For more information consult a cardiologist online --> https://www.icliniq.com/ask-a-doctor-online/cardiologist

Last reviewed at: 07.Sep.2018

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