Brugada Syndrome: A Case Report

Brugada syndrome is an inherited cardiovascular disorder. Approximately 25% of individuals affected with Brugada syndrome demonstrate a mutation in the SCN5a sodium channel. The main symptom is irregular heartbeats and, without treatment, may potentially result in sudden death. Frequently, sudden death can be the first manifestation of the disease. It is characterized by a pattern of ST segment elevation in the precordial leads on an electrocardiogram (ECG) due to a sodium channelopathy. This case report highlights the case of a 12-year-old female who presented to the emergency department due to syncope, and had an ECG consistent with Brugada syndrome.

A healthy 12-year-old girl that was admitted to the Emergency Department due to syncope at midnight, Family history was negative. In the ambulance, ECG showed VT that responded to the treatment by Procor IV. In the Emergency Department she was ill appearing, but she was well-hydrated and non-toxic in appearance. Physical examination showed stable vital signs. On physical On cardiac exam, she was tachycardic with an irregular rhyth exam. There were no murmurs, rubs, or gallops heard. Her lungs were clear to auscultation bilaterally. Her abdomen was soft and non-tender. The laboratory tests showed normal values of magnesium; Troponin and CPK were normal. The ECG showed a Picture of Brugada Syndrome, sinus rhythm with frequent premature ventricular contractions, a right axis, and coved ST elevation in V1–V2. (Image 1). A chest x-ray was normal, Echocardiogram without evidence of myocarditis or cardiomyopathy. The child was sent to the ICU and treated with Procor and β-blockers. Followed by electrophysiological evaluation for ICD transplantation.

Brugada syndrome is a very rare arrhythmia disorder. The physicians must think of it when repeated syncope and/or nightmare were found in healthy children and try to find the typical ECG findings.