Brugada Morphology

Report:

Sinus rhythm 80/min

Left axis deviation – 35o

Nonspecific T wave changes 3, aVF, V5-6

V1-2 ST elevation c/c Brugada’s syndrome

Comment:

This is a not infrequent problem in Casualty (see also Case 17): what to do with a patient whose ECG has a signature of a potentially lethal condition. The answer is simple: once an ECG is taken, get a Cardiologist to deal with the problem. If the history (e.g., unexplained syncope, family sudden deaths, etc) is significant, admit for monitoring.

The ECG remained stable over 4 hours (Fig 39a). However, no drug challenge or other manœuvre was undertaken. Most likely – lacking family or personal history of relevant events - this was a normal variant42.

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