Professional paper
Brugada Syndrome and Right Ventricle Morphofunctional Abnormalities on Echocardiography in Young Male with Family Anamnesis of Sudden Cardiac Death
Robert Steiner
; »J. J. Strossmayer« University, School of Medicine Osijek, Clinical Department of Cardiovascular Diseases and Intensive Care, Osijek, Croatia
Sandra Makarovic
; »J. J. Strossmayer« University, School of Medicine Osijek, Clinical Department of Cardiovascular Diseases and Intensive Care, Osijek, Croatia
Zorin Makarovic
; »J. J. Strossmayer« University, School of Medicine Osijek, Clinical Department of Cardiovascular Diseases and Intensive Care, Osijek, Croatia
Ines Bilic-Curcic
; »J. J. Strossmayer« University,School of Medicine Osijek, Clinical Department of Endocrinology, Diabetes and Metabolism Disorders, Osijek, Croatia
Abstract
First presented by Brugada and Brugada in 1992, Brugada Syndrome (BrS) is a primary electrical disease of the heart that causes sudden cardiac death or life-threatening ventricular arrhythmias. This disease is hereditary autosomic dominant transmitted and genetically determined. The syndrome has been linked to mutations in SCN5A, the gene encoding for the α-subunit of the sodium channel. Electrocardiogram (ECG) abnormalities indicating Brugada syndrome, include repolarization and depolarization abnormalities in the absence of identifiable structural cardiac abnormalities or other conditions or agents known to lead to ST-segment elevation in the right precordial leads (V1-V3). Intravenous administration of sodium channel blocking drugs may modify the ECG pattern. Ajmaline, flecainide, procainamide and propafenone exaggerate the ST-segment elevation or unmask it when it is initially absent. An implantable cardioverter-defibrillator (ICD) is the only proven effective device treatment for the disease. Although BrS is primary electrical disease, some authors have suggested the presence of morphological and functional abnormalities mainly located in the right ventricle (RV), notably in the outflow tract (RVOT). In this short report we will present a young male, with predisposition and positive family history of sudden cardiac death, with complete diagnostic procedure including propafenon testing unmasking Brugada syndrome. An echosonography revealed dilated apical right ventricle, suggesting BrS is not only electrical disorder, but may include morphofunctional abnormalities, described in previous reports. In addition, we reviewed the possible connection between Brugada syndrome and morphological abnormalities in RV.
Keywords
Brugada syndrome; sudden cardiac death; electrical disorder; sodium chanel blocking agents; inheritance; propafenon test; morphological abnormalities in RV; implantable cardioverter defibrillator; arrhytmogenic right ventricular cardiomyopathy; ST-segment elevation in the right precordial leads
Hrčak ID:
120926
URI
Publication date:
31.3.2014.
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