Brugada syndrome

Description

Brugada (brew-GAH-dah) syndrome is a rare, but potentially life-threatening heart rhythm condition (arrhythmia), which is sometimes hereditary.

People with Brugada syndrome have an increased risk of irregular heart rhythms beginning in the lower chambers of the heart (the ventricles).

Treatment of Brugada syndrome includes preventive measures such as fever reduction and to avoid drugs that may cause an arrhythmia. Some people with Brugada syndrome need of a medical device called an implantable cardioverter defibrillator (ICD).

Symptoms

The Brugada syndrome often does not cause any noticeable symptoms. Many people with Brugada syndrome do not know they have it.

The signs and symptoms that may be associated with the Brugada syndrome include:

  • Dizziness
  • Fainting
  • Panting and wheezing, especially at night
  • Irregular heartbeat or palpitations
  • Extremely fast and chaotic heart beat
  • Seizures

A great sign of Brugada syndrome is an irregular result of an electrocardiogram (ECG), a test that measures the electrical activity of the heart.

When to see a doctor

The Brugada syndrome signs and symptoms are similar to those of other heart rhythm disorders. It is important to see a health care professional to find out whether the Brugada syndrome, or other heart rhythm disorder that is causing the symptoms.

If you faint and you think it can be due to a disease of the heart, seek emergency medical attention.

If your father, mother, brother or son has been diagnosed with Brugada syndrome, you may want to ask your provider if you have tests to see if you are at risk of Brugada syndrome.

Causes

The Brugada syndrome is a heart rhythm disorder. Each heartbeat is triggered by an electrical signal made by special cells in the upper right chamber of the heart. Small pores, called channels, in each of these cells direct of this electrical activity, which causes the heart to beat.

In the Brugada syndrome, a change in these channels causes the heart to beat too fast, creating a dangerous heart rhythm (ventricular fibrillation).

As a result, the heart does not pump enough blood to the rest of the body. An irregular rhythm that lasts for a short period of time can cause fainting. Sudden cardiac death can occur if the irregular beat of the heart is not stopped.

Brugada syndrome can be caused by:

  • A structural problem in the heart, that can be difficult to detect
  • An imbalance of the chemical substances that help to send electrical signals through the body (electrolyte)
  • Use of certain prescription drugs or cocaine

Risk factors

The risk factors for Brugada syndrome include:

  • The family history of Brugada syndrome. This condition is often transmitted from parents to children (inherited). Have members of the family with Brugada syndrome increases the risk of a person have, too.
  • The fact of being a man. Men are more frequently diagnosed with Brugada syndrome than women.
  • Of the race. The Brugada syndrome occurs more frequently in Asians than in people of other races.
  • Fever. A fever does not cause Brugada syndrome, but it can irritate the heart and cause fainting or sudden cardiac arrest in people with Brugada syndrome, especially in children.

Complications

The complications of Brugada syndrome requires emergency medical attention. The Brugada syndrome complications include:

  • The sudden cardiac arrest. If not treated immediately, this sudden loss of heart function, breathing and consciousness, which often occurs during sleep, it is deadly. With fast, appropriate medical care, survival is possible.
  • Fainting. With the Brugada syndrome, fainting requires emergency medical attention.

Prevention

If someone in your family has Brugada syndrome, genetic testing may be done to determine if you have or are at risk of the disease.

Brugada syndrome

Diagnosis

The Brugada syndrome is usually diagnosed in adults and, sometimes, in adolescents. Rarely is diagnosed in young children because the symptoms are often unnoticed.

To diagnose Brugada syndrome, a health care provider will perform a physical exam and listen to the heart with a stethoscope. Tests are done to check the beating of the heart and to diagnose or confirm the Brugada syndrome.

  • Electrocardiogram (ECG) with or without medication.An electrocardiogram (ECG) is a method of quick, painless test that records the electrical signals in the heart. For one, sensors (electrodes) are attached on the chest and sometimes the limbs. The test can help detect problems with the heart's rhythm and structure. If a heartbeat is regular during the test, the next step could be to use a portablefor a day and a night. This type of test is called a 24 hour Holter monitor test. Some people have symptoms of Brugada syndrome, but the results of your initial electrocardiograms (ECGs) and 24-hour Holter tests are within the standard range. These people may have additionalECGsthat include drugs that are administered via an INTRAVENOUS injection that may cause irregular heartbeat.
  • The echocardiogram. An echocardiogram uses sound waves to create images of the heart. This test cannot diagnose Brugada syndrome on its own, but can help identify structural problems with the heart.
  • Electrophysiology (EP) and assignment tests.This test, also called an electrophysiology (EP) study, it can be done in some people with suspected Brugada syndrome. In this test, a health care provider of fine threads, flexible tubes (catheters) with the tip of the electrodes through the blood vessels to different areas within the heart. Once in place, the electrodes can show the propagation of electrical signals through the heart.

Electrocardiogram (ECG) with or without medication. An electrocardiogram (ECG) is a method of quick, painless test that records the electrical signals in the heart. For one , sensors (electrodes) are attached on the chest and sometimes the limbs. The test can help detect problems with the heart's rhythm and structure.

If a heartbeat is regular during the test, the next step could be to use a laptop for a day and a night. This type of test is called a 24 hour Holter monitor test.

Some people have symptoms of Brugada syndrome, but the results of your initial electrocardiograms (ECGs) and 24-hour Holter tests are within the standard range. These people may have more ECGs that include drugs that are administered via an INTRAVENOUS injection that may cause irregular heartbeat.

Electrophysiology (EP) and assignment tests. This test, also called an electrophysiology (EP) study, it can be done in some people with suspected Brugada syndrome.

In this test, a health care provider of fine threads, flexible tubes (catheters) with the tip of the electrodes through the blood vessels to different areas within the heart. Once in place, the electrodes can show the propagation of electrical signals through the heart.

Treatment

The treatment for Brugada syndrome may include medications, procedures, catheter or surgery to implant a device that controls the heartbeat. The Brugada syndrome, the treatment depends on the risk of having a serious irregular heart rhythm (arrhythmia).

High-risk means having:

  • A personal history of serious arrhythmias
  • Fainting
  • Survived a sudden cardiac arrest

If you have Brugada syndrome, but does not have symptoms, you may not need specific treatment because the risk of severe irregular heartbeat is probably low. However, a health care provider may recommend that you take measures to reduce the risk of an irregular heartbeat.

  • Treat fever aggressively. The fever is a known trigger of irregular heartbeats in people with Brugada syndrome. The use of fever-reducing medications at the first sign of a fever.
  • Avoid drugs that may trigger an irregular heartbeat.Many drugs can increase the risk of irregular heartbeat, including certain heart medications and antidepressants. Excess alcohol can also increase the risk. Tell your doctor about the medicines you take, including prescription and supplements that you buy without a prescription.
  • Avoid playing competitive sports. This would apply to people at high risk of a serious irregular heart rhythm. Ask your doctor if you should avoid this type of sporting activities.

Avoid drugs that may trigger an irregular heartbeat. Many drugs can increase the risk of irregular heartbeat, including certain heart medications and antidepressants. Excess alcohol can also increase the risk.

Tell your doctor about the medicines you take, including prescription and supplements that you buy without a prescription.

Drugs

Some people with Brugada syndrome are prescribed drugs, such as quinidine, to avoid a situation that is potentially dangerous for the heart rate. These drugs can be prescribed alone or with a medical device called an implantable cardioverter defibrillator (ICD) — that controls the heartbeat.

Surgery or other procedures

People with Brugada syndrome who have had a cardiac arrest, or a troubling episode of fainting, you may need surgery or a catheter procedure.

  • An Implantable cardioverter defibrillator (ICD).This small battery-operated device placed in the chest to continuously monitor the heart rhythm. Offers electric shock when it is necessary to control irregular heartbeats. an implantable cardioverter defibrillator (ICD) placement usually requires an overnight stay in the hospital. mplantable cardioverter-defibrillators (Icds) can deliver crisis when they are not needed, so it is important to discuss the benefits and risks of these devices with a health care provider.
  • The ablation catheter. If an ICD is not effectively and safely control the symptoms of Brugada syndrome, a procedure called radiofrequency catheter ablation may be an option. A long, flexible tube (catheter) that is inserted through a blood vessel and threaded to the heart. The catheter delivers high-energy that the scars or destroys the heart tissue responsible for the irregular rhythm of the heart.

An Implantable cardioverter defibrillator (ICD). This small battery-operated device placed in the chest to continuously monitor the heart rhythm. Offers electric shock when it is necessary to control irregular heartbeats. an implantable cardioverter defibrillator (ICD) placement usually requires an overnight stay in the hospital.

mplantable cardioverter-defibrillators (Icds) can deliver crisis when they are not needed, so it is important to discuss the benefits and risks of these devices with a health care provider.

If you have Brugada syndrome, you need regular medical checkups to make sure that the heart rhythm disorder is properly managed and controlled. Regular check-ups can help your doctor to detect early complications and to determine if a treatment change is needed.

Coping and support

Discover that you have Brugada syndrome can be a challenge. You may worry if your treatment will work or if other members of the family could be at risk.

Going back to friends and family for support is essential. If you find that you need more help, talk to your health care provider about joining a support group. Connect with others in a support group can help ease the stress associated with the Brugada syndrome.

Preparing for your appointment

It is likely to take several appointments with your health care provider to confirm a diagnosis of Brugada syndrome and its severity. Your healthcare provider can give you instructions on how to prepare prior to each visit.

Here's some information to help you prepare for your first appointment.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there is anything that you need to do beforehand. For example, if you are taking a test to evaluate the heart's electrical activity (electrophysiology of the test), ask your doctor how long you need to fast before the test.
  • Write down your symptoms, including any that seem unrelated to the Brugada syndrome, and when they began.
  • Write down key personal information, especially any family history of sudden death, heart attack, or heart disease, and any personal history of fainting or cardiac arrhythmias.
  • Make a list of all medications, vitamins or supplements that you take, including over-dose.
  • Have a family member or friend along, if possible. Someone who accompanies you may remember something that you missed or forgot.
  • Write down your questions so that your health care provider.

For the Brugada syndrome, some basic questions to ask include:

  • What is the most likely cause of my symptoms?
  • What tests do I need?
  • What types of treatments available for the Brugada syndrome? What do I recommend?
  • What is an appropriate level of physical activity?
  • How often will I need follow-up visits to monitor my condition?
  • I have other health conditions. How can I best manage these conditions?
  • Are there brochures or other printed material that I can take my house? What sites do you recommend?
  • My family must be defended?

Don't hesitate to ask any questions you may have.

What to expect from your doctor

Your doctor may ask you a series of questions, such as:

  • Do you always have symptoms, or the symptoms come and go?
  • How often do you have signs, such as fainting?
Symptoms and treatment of Brugada syndrome