Brugada Syndrome

Definition

What is Brugada syndrome?

Brugada syndrome is a condition where our heart beat is irregular. It is one of the causes of sudden cardiac arrest and sudden cardiac death. This condition is a genetic disorder characterized by abnormal heart rhythms from the lower chambers of the heart. This abnormality is referred a Brugada ECG pattern and can be recognized by electrocardiogram (ECG) test.

How common is Brugada syndrome?

This health condition is more common in men than in woman (ratio 10:1). The first signs of Brugada usually occur at the age of 22-65 years old. In South East Asian, the average age was 40, 41 years.

This condition is not common in children, it is plausible. Therefore, early diagnosis is necessary to prevent complications. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of Brugada syndrome?

Symptoms of Brugada syndrome often occurs at night (nocturnal hypoglycemic episode) and or after consuming alcohol. Sometimes it also can suddenly appear and turn severe after working out or even after a meal.

The reason Brugada syndrome is fatal is because in many cases, the abnormal heart rhythm persists, and causes the heart to stop pumping.

The symptoms of Brugada syndrome include:

• Fever;
• Fatigue;
• Dyspnea;
• Nervous;
• Skipped heart beats (sudden cardiac arrest or ventricular arrhythmias);
• Chest pain, heavy, wheezing;
• Heart palpitations;
• Fainting/syncope;
• Stroke.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

You should contact your doctor if you have any of the following:

• Having family member experienced Brugada syndrome;
• Having heart palpitations or an irregular heartbeat;
• Using medications that elevate heart rate, such as procainamide, flecainide;
• Previous fainting, arrhythmias in nervous/fever episode.

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes Brugada syndrome?

Many studies on Brugada syndrome point back to genetic mutation as the main cause. In fact, 25% of all cases of Brugada have some type of gene mutation. The SCN5A gene (a gene that determines ion channels function and electrical activity) is most often involved, but only in around a third of cases.

Ion channels are located on the heart surface as tiny openings that allow electric signals to pass into the heart muscle. This causes contraction and creates heartbeat, pumping blood from the heart to other organs in the body.

Mutation in the SCN5A gene causes the heart to contract faster and therefore lead to Brugada syndrome. Other cases show abnormality in heart structure in the right ventricular that lead to an unregulated heartbeat. Some medications, such as cocaine and psychotropic drugs, can cause the heart rate to increase as well.

Risk factors

What increases my risk for Brugada syndrome?

Male patient with a family history of heart problem are at a higher risk of Brugada syndrome. This condition is more common in people in their 40s. Other risk factors include:

• Having previous sudden cardiac arrest and or unexplained syncope;
• Having ventricular tachycardia or sustained arrhythmias;
• Asymptomatic dysfunction history;
• Cocaine, psychotropic drugs abuse.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is Brugada syndrome diagnosed?

This health condition can be diagnosed by some tests such as:

• Electrocardiogram (ECG);
• Electrophysiology (EP) test;
• Genetic testing;
• Imagine tests such as ultrasound and MRI.

How is Brugada syndrome treated?

Brugada syndrome is treatable with an implantable cardiac defibrillator (ICD). This machine senses dangerous abnormal heart rate and uses electric shock to send your heart back to its normal beating.

ICD is the most efficient method. However, ICD implantation carries some risks, including a relatively high rate of inappropriate shocks during normal rhythm and causing unwanted pain.

Medications such as quinidine have shown promise in small studies to reduce the risk of abnormal heart rate. It can be used together with ICD to prevent Brugada syndrome.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage Brugada syndrome?

The following lifestyles and home remedies might help you cope with Brugada syndrome:

Brugada syndrome is an inheritable disorder. Therefore, there is nothing you can do for prevention. However, living with Brugada can be emotionally challenging. There are ways to cope with your feelings about your condition, including:

• Joining a support group;
• Having continuous medical checkups to avoid complications.

If you have any questions, please consult with your doctor to better understand the best solution for you.