ECG Guru - Instructor Resources - Brugada Syndrome https://www.ecgguru.com/ecg/brugada-syndrome en BRUGADA PATTERN https://www.ecgguru.com/blog/brugada-pattern <div class="field field-name-field-blog-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/blog/brugada-pattern"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/Brugada%20f%C3%BCr%20Ecgguru.jpg" width="3645" height="1774" alt="" /></a></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p class="MsoNormal" style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 18px; font-family: Lato, sans-serif;">This patient is a 50-year-old man. His brother was diagnosed with epilepsy and died during a seizure at the age of 21.</p> <p class="MsoNormal" style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 18px; font-family: Lato, sans-serif;">Parts of the following text I have taken over from Dawn`s explanation on Brugada pattern/Brugada syndrome:</p> <p class="MsoNormal" style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 18px; font-family: Lato, sans-serif;">This ECG shows a “classic” Brugada pattern. Brugada Syndrome is a hereditary disease that is associated with a high risk of sudden cardiac death. It is due to a mutation in the sodium channel gene (channelopathy).</p> <p class="MsoNormal" style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 18px; font-family: Lato, sans-serif;">The ECG characteristics are:&nbsp;<span style="box-sizing: border-box; display: initial !important; font-size: 20px !important; font-family: Symbol;"><span style="box-sizing: border-box; display: initial !important; font-size: 7pt; font-variant-numeric: normal; font-stretch: normal; line-height: normal; font-family: 'Times New Roman';">&nbsp; &nbsp; &nbsp;</span></span><span style="text-indent: -0.25in;">ST elevation in V1 through V3 of at least 2 mm at the J point in the right precordial leads (V1-V3).</span></p> <p class="MsoListParagraphCxSpLast" style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 18px; font-family: Lato, sans-serif; text-indent: -0.25in;"><span style="box-sizing: border-box; display: initial !important; font-size: 20px !important; font-family: Symbol;">·<span style="box-sizing: border-box; display: initial !important; font-size: 7pt; font-variant-numeric: normal; font-stretch: normal; line-height: normal; font-family: 'Times New Roman';">&nbsp; &nbsp; </span></span>Coved upward ST segments with &nbsp;negative T waves in the affected leads.</p> <p class="MsoListParagraphCxSpLast" style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 18px; font-family: Lato, sans-serif; text-indent: -0.25in;"><span style="text-indent: -0.25in;">&nbsp; &nbsp; Brugada&nbsp;</span><span style="box-sizing: border-box; font-weight: bolder;">Syndrome&nbsp;</span><span style="text-indent: -0.25in;">is diagnosed when the ECG pattern exists with one of the following:</span></p> <p class="MsoListParagraphCxSpFirst" style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 18px; font-family: Lato, sans-serif; text-indent: -0.25in;"><span style="box-sizing: border-box; display: initial !important; font-size: 20px !important; font-family: Symbol;">·<span style="box-sizing: border-box; display: initial !important; font-size: 7pt; font-variant-numeric: normal; font-stretch: normal; line-height: normal; font-family: 'Times New Roman';">&nbsp; &nbsp; &nbsp;</span></span>Polymorphic ventricular tachycardia (VT) or ventricular fibrillation.</p> <p class="MsoListParagraphCxSpFirst" style="box-sizing: border-box; margin: 0px 0px 15px; padding: 0px; font-size: 18px; font-family: Lato, sans-serif; text-indent: -0.25in;">&nbsp; &nbsp; We can assume that his brother had the same disease (undiagnosed) and died from Brugada Syndrome.</p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/703/feed" method="post" id="fivestar-custom-widget" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--2" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give BRUGADA PATTERN 1/5</option><option value="40">Give BRUGADA PATTERN 2/5</option><option value="60">Give BRUGADA PATTERN 3/5</option><option value="80">Give BRUGADA PATTERN 4/5</option><option value="100">Give BRUGADA PATTERN 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="empty">No votes yet</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-PklKlXRbSL051Rw11mT1CoiDQgGBPfDSYzrVNOnpCrM" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_1"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fblog%2Fbrugada-pattern&amp;title=BRUGADA%20PATTERN"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> <script type="text/javascript"> <!--//--><![CDATA[//><!-- if(window.da2a)da2a.script_load(); //--><!]]> </script></span></li> </ul> Wed, 02 Aug 2023 08:01:19 +0000 Dr A Röschl 859 at https://www.ecgguru.com https://www.ecgguru.com/blog/brugada-pattern#comments Brugada Pattern https://www.ecgguru.com/ecg/brugada-pattern-0 <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/brugada-pattern-0"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/Misc%20101%20Brugada.png" width="1800" height="506" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p class="MsoNormal">This patient is a 50-year-old man with a history of epilepsy and early dementia. He had a VP shunt placed in the hospital and was then discharged home.&nbsp; He became extremely weak, which was not characteristic of him, and 911 was called.&nbsp; He was transported to the hospital uneventfully. He was found to be afebrile.</p><p class="MsoNormal">This ECG shows a “classic” Brugada pattern. Brugada Syndrome is a hereditary disease that is associated with a high risk of sudden cardiac death. It is due to a mutation in the sodium channel gene (channelopathy). The ECG characteristics are:</p><p class="MsoListParagraphCxSpFirst" style="text-indent: -.25in; mso-list: l2 level1 lfo1;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span><!--[endif]-->ST elevation in V1 through V3 of at least 2 mm at the J point in the right precordial leads (V1-V3).</p><p class="MsoListParagraphCxSpLast" style="text-indent: -.25in; mso-list: l2 level1 lfo1;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span><!--[endif]-->Coved upward ST segments with &nbsp;negative T waves in the affected leads.</p><p class="MsoNormal">Brugada <strong>Syndrome </strong>is diagnosed when the ECG pattern exists with one of the following:</p><p class="MsoListParagraphCxSpFirst" style="text-indent: -.25in; mso-list: l1 level1 lfo2;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></span><!--[endif]-->Polymorphic ventricular tachycardia (VT).</p><p class="MsoListParagraphCxSpFirst" style="text-indent: -.25in; mso-list: l1 level1 lfo2;"><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></span><span style="text-indent: -0.25in; font-size: 13.008px;">Documented ventricular fibrillation.</span></p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l1 level1 lfo2;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></span><!--[endif]-->A family history of sudden cardiac death at less than 45 years of age.</p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l1 level1 lfo2;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></span><!--[endif]-->Brugada-type ECG changes in family members.</p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l1 level1 lfo2;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></span><!--[endif]-->VT is inducible with programmed electrical stimulation.</p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l1 level1 lfo2;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></span><!--[endif]-->Syncope.</p><p class="MsoListParagraphCxSpLast" style="text-indent: -.25in; mso-list: l1 level1 lfo2;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></span><!--[endif]-->Sleep disorders, including nocturnal agonal respiration.</p><p class="MsoListParagraphCxSpLast" style="text-indent: -.25in; mso-list: l1 level1 lfo2;">&nbsp;</p><p class="MsoNormal">Brugada Syndrome was described in 1992 by the Brugada brothers.&nbsp; It’s incidence is particularly high in Southeast Asia, but is a leading cause of death (after trauma) in males under 40 worldwide.</p><p class="MsoNormal">The ECG signs can come and go, and can be unmasked by multiple factors, including:</p><p class="MsoListParagraphCxSpFirst" style="text-indent: -.25in; mso-list: l0 level1 lfo3;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></span><!--[endif]-->Fever</p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l0 level1 lfo3;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></span><!--[endif]-->Ischemia</p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l0 level1 lfo3;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></span><!--[endif]-->Drugs (Na channel blockers, Ca channel blockers, alpha agonists, beta blockers, cocaine, alcohol, and others)</p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l0 level1 lfo3;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></span><!--[endif]-->Hypokalemia</p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l0 level1 lfo3;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></span><!--[endif]-->Hypothermia</p><p class="MsoListParagraphCxSpLast" style="text-indent: -.25in; mso-list: l0 level1 lfo3;"><!--[if !supportLists]--><span style="font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;">·<span style="font-variant-numeric: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: 'Times New Roman';">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;</span></span><!--[endif]-->Post DC cardioversion</p><p class="MsoListParagraphCxSpLast" style="text-indent: -.25in; mso-list: l0 level1 lfo3;">&nbsp;</p><p class="MsoNormal">The definitive treatment for confirmed Brugada Syndrome is an implanted cardiac defibrillator.&nbsp; We do not know if the patient featured here was definitively diagnosed with Brugada Syndrome, but the ECG is an excellent example of the characteristic ST and &nbsp;wave changes.</p><p class="MsoNormal">&nbsp;</p><p class="MsoNormal">Our gratitude to Palm Beach Gardens, FL, Fire Rescue Dept and Lew Steinberg for donating this tracing to the ECG Guru &nbsp;</p><p class="MsoNormal"><strong>References</strong></p><p class="MsoNormal">Burns, E. (2017). Brugada Syndrome. <em>Life In The Fast Lane</em>.&nbsp; Accessed from&nbsp;&nbsp;<a href="https://www.lifeinthefastlane.com/ecg-library/brugada-syndrome/amp">https://www.lifeinthefastlane.com/ecg-library/brugada-syndrome/amp</a><span style="font-size: 13.008px;">&nbsp;</span></p><p class="MsoNormal">Postema, P.G. (2013). Brugada Syndrome. &nbsp;<em>ECGpedia. </em>Accessed from<em> </em><a href="http://en.ecgpedia.org/wiki/Brugada_Syndrome">http://en.ecgpedia.org/wiki/Brugada_Syndrome</a></p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/703/feed" method="post" id="fivestar-custom-widget--2" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--4" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Brugada Pattern 1/5</option><option value="40">Give Brugada Pattern 2/5</option><option value="60">Give Brugada Pattern 3/5</option><option value="80" selected="selected">Give Brugada Pattern 4/5</option><option value="100">Give Brugada Pattern 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >3.5</span></span> <span class="total-votes">(<span >8</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--2" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-2jZWhMXb4JRCMgTMgkiyIbrt-wSYnIntGbIpOOH_Dp8" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/brugada-syndrome" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Brugada Syndrome</a></div><div class="field-item odd"><a href="/ecg/brugada" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Brugada</a></div><div class="field-item even"><a href="/ecg/brugada-pattern" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Brugada pattern</a></div><div class="field-item odd"><a href="/ecg/channelopathy" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Channelopathy</a></div><div class="field-item even"><a href="/ecg/st-elevation" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ST elevation</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_2"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fbrugada-pattern-0&amp;title=Brugada%20Pattern"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Tue, 06 Jun 2017 20:41:43 +0000 Dawn 731 at https://www.ecgguru.com https://www.ecgguru.com/ecg/brugada-pattern-0#comments