Brugada Flashcards
Neuro dd of Brugada
FA- freidrichs ataxia T-thiamine def D-dmd
What will u look for in CXR in Brugada pattern
Mediastinal mass compressing RVOT
Echo considerations in Brugada
RA- nil sp RV- RVMI,arvd, acute PE LA-nil sp LV-myocarditis Ao-dissection Pericardium-pericarditis, hemopericardium
ECG considerations in Brugada
RBBB.,LBBB,LVH,Early repolarisation
Long QT 3
Hyperkalemia,Hypercalcemia
Brugada is due to
Sodium channelopathy
Brugada sign is
Coved ST >2 mm in 2 or more of V1-3 with neg T wave i.e. Type 1 pattern is called Brugada sign
Brugada sign plus —- diagnoses Brugada syndrome
Clinical criteria
- VF or Polymorphic VT
- Family h/o of SCD less than 45
- Brugada sign in family members
- Inducible VT in EPS
- Syncope (likely due to tachyarrhythmia)
- Nocturnal agonal respiration
2005 consensus conference
Mean age of sudden death in Brugada
41 yrs
Type 3 Brugada pattern is
Less than 2 mm ST elevation
Leads used for Brugada diagnosis
V1-3
It’s V1& 2 only as per 2013 HRS Guidelines
Latest as of 2018 April
Non diagnostic Brugada patterns
Type 2 and 3
Right precordial leads are
V1-2
As per 2013 HRS Guidelines
Common feature of all 3 Brugada patterns
J point elevation of 2 mm or more
Not ST segment.
Preferred intercostal space for ECG in Brugada
2nd ICS
Type 1 ECG pattern with no clinical criteria is called
Idiopathic Brugada ECG pattern
Most controversial topic in Brugada
Value of EPS
Dec 2017 review for HRS Guidelines JACC- Doesn’t support EPS in most Asymptomatic Brugada pattern
Only drug which maybe useful in Brugada
Quinidine And Amiodarone
Two diseases caused by SCN5A mutations
Brugada and Lng QT3 syndrome
Both are autosomal dominant
When does Brugada and Long QT 3 manifest
Brugada in adulthood in males
Long QT3 usually in teenage years
Drugs increasing ST elevation in. Brugada
Beta blockers, Class I A and C
Drugs which increase ST elevation of Brugada but decreases arrythmogenicity in Long QT 3
Beta blockers
Drugs which increases arrythmogenicity in Brugada but reduces in Long QT 3
Class I A and C
Brugada pattern in ECG could be an early sub clinical manifestation of
ARVD