Electrocardiographical case. Asymptomatic patient with ST-segment elevation.
A 46-year-old man complained of recurrent episodes of giddiness which was not associated with chest pain or breathlessness. There was no family history of sudden death. Clinical examination was unremarkable.12-lead electrocardiogram (ECG) showed ST segment elevation in the right precordial leads, with coved ST segment elevation at its J point followed by a negative T wave with no isoelectric separation, specifically in V2. These ECG features are characteristic of the Brugada syndrome. He underwent a flecanide challenge which produced further elevation of ST segment at its J point and spontaneous ventricular ectopy. Electrophysiological studies induced ventricular fibrillation with 3 extra stimuli. An implantable cardioverter-defibrillator was implanted for prevention of sudden cardiac death. The Brugada syndrome is discussed.
Ching
C K
CK
Department of Cardiology, National Heart Centre, Mistri Wing, Third Hospital Avenue, Singapore 168752.
Teo
W S
WS
D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000209:etiology; D017147:Defibrillators, Implantable; D003937:Diagnosis, Differential; D004244:Dizziness / Q000209:etiology; D004502:Education, Medical, Continuing; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013577:Syndrome; D014693:Ventricular Fibrillation / Q000139:chemically induced