title: Brugada syndrome with atypical ECG: downsloping ST-segment elevation in inferior leads.
abstract: We present an unusual case of a young Thai immigrant, symptomatic, who had suffered prior episodes of syncope with strong family background: male, first-degree relatives, younger than 45 years old who had died suddenly. The rest ECG, with the patient asymptomatic at the time, showed persistent ST-segment elevation, in inferior leads and "mirror" image in the anterior wall, which were not modified with sublingual nitrates, in absence of demonstrable structural heart disease by chest X-rays and echocardiogram, hypothermia, ischemia, or electrolytic disorders. Holter monitoring revealed at dawn, a short episode of polymorphic ventricular tachycardia of short onset extrasystole coupling, which evolved into asystole and sudden cardiac death. We believe this is a sudden unexplained death syndrome, although we did not have a chance to conduct a genetic study.
authors.affiliation: ABC Foundation, Santo André, São Paulo, Brazil. riera@uol.com.br
authors.forename: Andrés Ricardo Pérez
authors.initials: AR
authors.lastname: Riera
authors.forename: Celso
authors.initials: C
authors.lastname: Ferreira
authors.forename: Edgardo
authors.initials: E
authors.lastname: Schapachnik
authors.forename: Paulo Cesar
authors.initials: PC
authors.lastname: Sanches
authors.forename: Paulo Jorge
authors.initials: PJ
authors.lastname: Moffa
mesh_terms: D000328:Adult; D016757:Death, Sudden, Cardiac; D004562:Electrocardiography; D006801:Humans; D008297:Male; D013577:Syndrome; D014693:Ventricular Fibrillation / Q000503:physiopathology*