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Colegio de Medicina Interna de México.

2008, Number 3

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Med Int Mex 2008; 24 (3)

Brugada syndrome in a patient with SCN 5A gene alteration. Case report and literature review

Jaramillo RH, Acosta MM, Aguilera ZR, Acosta H

Language: Spanish
References: 26
Page: 243-246
PDF size: 144.68 Kb.


ABSTRACT

Brugada syndrome is a cardiac entity with alteration in sodium channels, which predispose to a sudden death. It is an autonomic dominant alteration in 30% of cases. An electrocardiogram that shows a ST segment elevation, in V1-V3, can diagnose these patients. Here we report a case of a 24-year-old patient that consults the clinician with cephalalgia and palpitations of 2 hours of evolution. In the admission room, an electrocardiogram was performed, which showed sinus tachycardia and elevation of the ST segment with saddleback characteristics of 1 mm and J point in V1 and V2. There were prescribed 100 mg each 12 hours of metoprolol and he was sent to home. 24-hours later, returns to the hospital center, showing the same symptoms, a new electrocardiogram was performed, this one had a ST segment elevation in V1 and V2, coved type with inverted ST segment. It was classified as a Brugada pattern, metoprolol was suspended and patient was discharged. A 24-hours Holter monitoring showed a sinus tachycardia, without arrhythmias. An electrocardiogram was made to his parents and a brother, finding out that him father has ST segment elevation coved type in V1 and V2. It was established that both have Brugada syndrome, asymptomatic until now. The genetic analysis of the patient showed a mutation G995A within the SC5NA gene. Symptoms were not justified by Brugada syndrome; it was valued by the psychiatric service, which established the diagnosis of anxiety disorder. The symptoms disappeared with the use of benzodiacepines and SSRI antidepressants.


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