Unexplained syncope, Brugada-like ECG and minimal structural right ventricular abnormalities: which is the right diagnosis?
We describe a 65-year-old man with unexplained syncope, Brugada ECG pattern and right ventricular abnormalities. To reach a diagnosis of Brugada syndrome, a variety of diseases have to be excluded. This case report shows how difficult the differential diagnosis is, particularly with arrhythmogenic right ventricular cardiomyopathy, after documentation of minimal structural RV abnormalities; invasive examination may be required. In this case, three-dimensional electroanatomical bipolar voltage mapping revealed a scar area in the right ventricle in the absence of clear-cut kinetic abnormalities, but the sensitivity of this method and specificity in patients without confirmed arrhythmogenic right ventricular cardiomyopathy have not been defined.
Marras
Elena
E
Department of Cardiology, Santa Maria dei Battuti Hospital, Conegliano, Italy. elena.marras@alice.it
Basso
Cristina
C
Sciarra
Luigi
L
Delise
Pietro
P
D000368:Aged; D001706:Biopsy; D053840:Brugada Syndrome / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000503:physiopathology; D017147:Defibrillators, Implantable; D003937:Diagnosis, Differential; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D006352:Heart Ventricles / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D013575:Syncope / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome