Slide 1: Spot this week’s distinctive EKG finding. [EKG]
Slide 2: Do those septal precordial leads look peculiar? [EKG]
Slide 3: Brugada sign: the diagnostic criteria. Formal definition: ST elevation in leads V1-V3 + accompanying negative T-wave + one of three morphologies: [EKGs showing Type 1: Coved (STE > 2mm), Type 2: Saddle-back (STE > 2mm), and Type 3: Saddle-back (STE < 2mm)]
Slide 4: EKG pattern confirmed! …What now? Assess for clinical manifestations (ventricular fibrillation or tachycardia, family history of sudden cardiac death, history of unexplained cardiogenic episode, presence of nocturnal agonal respiration) -> Present? Meets diagnostic criteria for Brugada Syndrome. ICD. | Just the isolated EKG pattern? Questionable significance. Consider an EP study.
References
- Mizusawa Y, Wilde AA. Brugada syndrome. Circ Arrhythm Electrophysiol. 2012 Jun 1;5(3):606-16. PMID 22715240
- Brugada J, Campuzano O, Arbelo E, Sarquella-Brugada G, Brugada R. Present Status of Brugada Syndrome: JACC State-of-the-Art Review. J Am Coll Cardiol. 2018 Aug 28;72(9):1046-1059. PMID 30139433
Tags: Brugada sign, Brugada syndrome, cardiology, EP, EP study, ICD, ST elevation