[The Brugada syndrome. To be evoked in case of malaise in a young adult]

Abstract

A DIAGNOSIS TO BE EVOKED: The Brugada syndrome is a rare but serious inherited disease that causes sudden cardiac death by ventricular tachycardia and fibrillation, especially in younger men. Diagnostic problems are related to the possible absence of symptoms although the electrocardiogram (ECG) reveals the characteristics of a Brugada syndrome and to the variations in the ECG in the same patient over time. THREE ELECTROCARDIOLOGICAL ASPECTS: Type 1 corresponds to the historical description with ST segment elevation at point J of at least 3 mm from its summit and upward convex ST segment followed by a negative T wave. In Type 2, the extent of point I is of 2 mm, the ST segment has a saddle form and remains at least 1 mm above the isoelectric line, the T wave is positive or biphasic. In Type 3, the terminal section of the ST segment never exceeds 1 mm above the isoelectric line. In the case of a Type 1 ECG, a pharmacodynamic test is of no interest. REGARDING TREATMENT: The only treatment to have demonstrated its efficacy is the implantable automatic defibrillator, indicated in symptomatic patients.