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- 84 bpm
- PR - Normal (~190ms)
- QRS - Normal (100ms)
- QT - 330ms (QTc Bazette 390 ms)
- ST Elevation lead V2 ~2mm
- Partial RBBB
- Left Atrial Abnormality
- Wide notched P wave in lead II
- Negative portion of P wave in V1 >40ms and >1mm
- History of collapse in a young patient
- Partial RBBB and ST elevation in V2
- ? Brugada Syndrome with a Type 2 (non-diagnostic) pattern
What happened ?
The patient was admitted under the cardiology team for further investigation.
A cardiac MRI and echo were both normal.
Given the concern of possible Brugada the patient underwent a flecainide challenge which was negative, excluding Brugada syndrome as a cause of the patient's syncope.
An implantable loop recorder (ILR) was inserted to monitor for further arrhythmogenic events and the patient was discharge with out patient cardiology follow-up.
We've covered Brugada Syndrome in detail back in July 2013, check out that post here:
More on Brugada here:
- The Cardiac Society of Australia and New Zealand Guidelines for the diagnosis and management of Brugada Syndrome
- Life in the Fast Lane - Brugada Syndrome
References / Further Reading
Life in the Fast Lane
- Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.