Brugada syndrome with atypical ECG: downsloping ST-segment elevation in inferior leads.
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.
Riera
Andrés Ricardo Pérez
AR
ABC Foundation, Santo André, São Paulo, Brazil. riera@uol.com.br
Ferreira
Celso
C
Schapachnik
Edgardo
E
Sanches
Paulo Cesar
PC
Moffa
Paulo Jorge
PJ
D000328:Adult; D016757:Death, Sudden, Cardiac; D004562:Electrocardiography; D006801:Humans; D008297:Male; D013577:Syndrome; D014693:Ventricular Fibrillation / Q000503:physiopathology*