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KMID : 1011920100110020038
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International Journal of Arrhythmia
2010 Volume.11 No. 2 p.38 ~ p.42
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A case of brugada syndrome presented as chest pain
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Lee Man-Young
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Abstract
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Brugada syndrome was described in 1992 as a new clinical entity characterized by electrocardiographic STsegment elevation in the right precordial leads (V1~V3) and the occurrence of sudden cardiac death (SCD) during its clinical course. Brugada syndrome is known to be linked with the mutations of SCN5A, the gene encoding αsubunit of the cardiac sodium channel. Furthermore, these abnormal cardiac sodium channels were found to show variable degrees of dysfunctioning in relation to changes in body temperature and electrocardiogram(ECG) findings of Brugada syndrome sometimes happen to reveal with the presence of high fever. We experienced a 44-year-old man with Brugada syndrome in whom the diagnosis of acute coronary syndrome had been mistakenly made because of an initial clinical presentation with complains of severe chest pain and accompanying ST segment elevations. The ST segment elevations in leads I and aVL, which extended the right precordial leads, led the physician to suspect transient pericarditis caused by coexisting pneumonia. In this case, a diagnosis of idiopathic Brugada syndrome was reconfirmed by a flecainide challenge test.
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KEYWORD
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brugada syndrome, ECG, fever, chest pain
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