Brugada Syndrome Mimicking Acute Coronary Syndrome

A Case of Brugada Syndrome Masquerading as Acute Coronary Syndrome in a Hispanic Male

Brugada syndrome is an aberrant ST-segment elevation in the right precordial leads. It can progress into sudden cardiac death (SCD) among patients with structurally normal hearts. Most patients are asymptomatic at presentation, but those who develop symptoms can present with syncope due to other arrhythmias such as ventricular tachycardia or fibrillation. Early diagnosis and appropriate management can prevent future complications in patients with a significant family history.

Brugada syndrome in the presence of coronary artery disease and parasympathomimetic drug therapy

Brugada pattern ECG changes have been described in various disease states and drug therapies, including electrolyte abnormalities, myocardial pathology, medications, and mechanical abnormalities. Therefore, the diagnosis of Brugada syndrome cannot be made in the presence of confounding variables according to prevailing guidelines. We present a case report which illustrates two important principles regarding Brugada syndrome, the dynamic ECG manifestations and the elimination of confounding variables (in this case significant coronary artery disease and cholinergic pharmacotherapy) prior to definitive diagnosis.