title: Worrisome thoughts about the diagnosis and treatment of patients with Brugada waves and the Brugada syndrome.
abstract: The Brugadas have made a significant contribution to medicine. Their discovery of a new clinical syndrome and ECG abnormalities has created a great deal of interest and has opened Pandora's box. Here, we discuss some worrisome thoughts about the condition. We stress the need for improved diagnostic criteria and treatment because it is not always possible to perform coronary arteriography, electrophysiological studies, right ventricular myocardial biopsy, and MRI in all patients in whom ST-segment abnormalities are seen in the ECG, especially in patients who are asymptomatic. Accordingly, further research is needed to guide the clinician in the diagnostic and therapeutic problems of patients who have unusual ST segments in leads V1 and V3. We present a patient who illustrates the problem.
authors.affiliation: Emory University School of Medicine, Department of Medicine, Division of Cardiology, Atlanta, Ga 30322, USA.
authors.forename: Joon
authors.initials: J
authors.lastname: Ahn
authors.forename: J Willis
authors.initials: JW
authors.lastname: Hurst
mesh_terms: D001208:Asia / Q000208:ethnology; D006328:Cardiac Catheterization; D002637:Chest Pain / Q000209:etiology; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004562:Electrocardiography / Q000187:drug effects; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis*; D006337:Heart Murmurs; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D017202:Myocardial Ischemia / Q000175:diagnosis; D011342:Procainamide; D013577:Syndrome; D014693:Ventricular Fibrillation / Q000175:diagnosis
chemical_list: D011342:Procainamide