title: Earliest electrocardiogram is golden for the diagnosis of Brugada syndrome.
abstract: Cardiac syncope can be classified as being either structural or dysrhythmogenic in origin, and it may be the only warning symptom of sudden cardiac death. One of the causes of dysrhythmic sudden cardiac death in young adults with structurally normal hearts is Brugada syndrome. Electrocardiogram (ECG) of Brugada syndrome is characterized by an ST-segment elevation in the right precordial leads. A 23-year-old man was presented to our emergency department (ED) with a history of syncope which has occurred 30 minutes before arrival and lasted for 10 minutes. Both physical and neurological examinations were unremarkable. Family history revealed coronary artery disease of his father and sudden death at 45. Initial ECG performed 3 minutes after his arrival showed a type 2 repolarization variant of Brugada syndrome. This pattern was reverted back to normal 5 minutes later and never showed up again on his future ECGs. In our case, it was only the earliest ECG that made the diagnosis possible since all future ECGs showed a perfectly normal pattern throughout the follow-up period. In all syncope patients, initial ECGs should be kept and filed to be reviewed again in case the primary physician is not competent enough for the evaluation of ECG.
authors.affiliation: Marmara University Pendik Education and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey.
authors.forename: Omer Faruk
authors.initials: OF
authors.lastname: Celik
authors.forename: Haldun
authors.initials: H
authors.lastname: Akoglu
authors.forename: Serkan
authors.initials: S
authors.lastname: Eroglu
authors.forename: Ozge
authors.initials: O
authors.lastname: Onur
authors.forename: Arzu
authors.initials: A
authors.lastname: Denizbasi
mesh_terms: D053840:Brugada Syndrome / Q000150:complications / Q000175:diagnosis*; D004562:Electrocardiography; D006801:Humans; D008297:Male; D013575:Syncope / Q000209:etiology; D013997:Time Factors; D055815:Young Adult