Brugada Morphology
Report:
Sinus rhythm 80/min
Left axis deviation â 35o
Nonspecific T wave changes 3, aVF, V5-6
V1-2 ST elevation c/c Brugadaâs 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 manÅuvre was undertaken. Most likely â lacking family or personal history of relevant events - this was a normal variant42.
39a. Repeat ECG barked at the wrong tree (septal ischæmia), but at least allowed the patient to go home. 40. 13 year old girl with chest pain
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