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Brugada syndrome

Syndroma Brugada · Brugadův syndrom

What it is

An inherited disorder of the heart's sodium channels (SCN5A in about a fifth) with a typical ECG pattern that can cause fatal ventricular arrhythmia, often in sleep or with fever; commoner in men and in Southeast Asia.

Symptoms & signs

  • Often none
  • fainting
  • gasping breathing at night
  • sudden cardiac arrest
  • ECG pattern unmasked by fever or drugs

🚩 Get help if…

  • call 112 / 911 now Collapse with no breathing — start CPR and use a defibrillator
  • call 112 / 911 now Fainting, especially during fever or sleep
  • call 112 / 911 now Gasping or noisy breathing at night
  • see a doctor soon Fever over 38.5 °C — bring it down fast and get an ECG

Where it strikes

Medical treatment

  • ECG, sometimes an ajmaline or flecainide challenge
  • ICD after cardiac arrest or with arrhythmic fainting
  • treat fever promptly with paracetamol
  • avoid trigger drugs (list at brugadadrugs.org)
  • quinidine for electrical storms or repeated shocks
  • screen relatives; genetic testing

Natural & lifestyle

  • Avoid heavy drinking and very large meals
  • treat every fever early

Emerging & experimental

  • Ablation of the right ventricular outflow tract surface
  • risk scores to choose who needs an ICD

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Magnesium supplements — untested anecdotal / traditional
  • Fish oil for arrhythmia prevention — trials in other heart disease negative not confirmed in trials

ICD codes