Brugada (brew-GAH-dah) syndrome is a rare, but potentially life-threatening heart rhythm disorder that is sometimes inherited.
People with Brugada syndrome have an increased risk of having irregular heart rhythms beginning in the lower chambers of the heart (ventricles).
Brugada syndrome treatments include preventive measures such as avoiding aggravating medications and reducing fever. When necessary, treatment may also include a medical device called an implantable cardioverter-defibrillator (ICD).
Many people with Brugada syndrome don't know they have the condition. Brugada syndrome often doesn't cause any noticeable symptoms.
Signs and symptoms that may be associated with Brugada syndrome include:
A major sign of Brugada syndrome is an abnormal result on an electrocardiogram (ECG), a test that measures the electrical activity of the heart.
Brugada syndrome signs and symptoms are similar to some other heart rhythm problems. It's important that you see your doctor to find out if Brugada syndrome or another heart rhythm problem is causing your symptoms.
If you faint and you think it may be because of a heart condition, seek emergency medical attention.
If your parent, sibling or child has been diagnosed with Brugada syndrome, you may want to ask your doctor if you should have testing to see if you're at risk of Brugada syndrome.
Brugada syndrome is a heart rhythm disorder. Each beat of your heart is triggered by an electrical impulse generated by special cells in the right upper chamber of your heart. Tiny pores, called channels, on each of these cells direct this electrical activity, which makes your heart beat.
In Brugada syndrome, a defect in these channels causes your heart to beat abnormally fast, creating a dangerous heart rhythm (ventricular fibrillation).
As a result, your heart doesn't pump enough blood to the rest of your body. You can faint if the abnormal rhythm lasts for a short time. Sudden cardiac death can occur if the abnormal heart beat doesn't stop.
Brugada syndrome may be caused by:
Risk factors for Brugada syndrome include:
Complications of Brugada syndrome require emergency medical care. They include:
If someone in your family has Brugada syndrome, genetic testing can be done to determine if you have, or are at risk of, the condition.
Brugada syndrome usually is diagnosed in adults and, sometimes, in adolescents. It's rarely diagnosed in young children because the symptoms are often unnoticed.
To diagnose Brugada syndrome, your doctor will perform a physical exam and listen to your heart with a stethoscope. Tests are done to check your heart beat and diagnose or confirm Brugada syndrome.
Electrocardiogram (ECG) with or without medication. An ECG is a quick, painless test that records the electrical signals in your heart. During an ECG, sensors (electrodes) are attached to your chest and sometimes your limbs. The test can help your doctor detect problems with your heart's rhythm and structure.
If your heart beat is normal during the test, your doctor may order a portable ECG that you wear during your daily activities for a full day and night. This type of test is called a 24-hour Holter monitor.
If you have symptoms of Brugada syndrome, but your initial ECG and 24-hour Holter test were normal, your doctor may give you medications through an IV that may trigger an abnormal heart beat.
Electrophysiology test. If your ECG shows signs of Brugada syndrome, or if you have had symptoms such as sudden cardiac arrest, your doctor may recommend an electrophysiology test to see how easy it is to get the heart to go into the abnormal Brugada rhythm.
In an electrophysiology test, a catheter is threaded through a vein in your groin to your heart. Electrodes are passed through the catheter to different points in your heart to map out any irregular heartbeats. The electrodes don't shock your heart — they just detect the electrical signals running through your heart.
Brugada syndrome treatment depends on your risk of a serious abnormal heartbeat.
You're considered at high risk if you have:
If you don't have any symptoms, you may not need any specific treatment because your risk is likely low. However, your doctor will recommend the following steps to reduce your chances of an abnormal heart rhythm.
If you've had cardiac arrest or a worrisome fainting episode, the main treatment is an implantable cardioverter-defibrillator (ICD).
If you have Brugada syndrome, it's important to schedule regular visits with your doctor to make sure you're properly managing your heart condition. Regular checkups can help your doctor decide if you need to change your treatment and may help catch any new problems early.
Finding out you have Brugada syndrome can be difficult. You may worry about whether your treatment will work or if other family members could be at risk.
Turning to friends and family for support is essential, but if you find you need more help, talk to your doctor about joining a support group. You may find that talking about your concerns with others who are experiencing the same difficulties can help.
If your doctor thinks you have Brugada syndrome, you'll likely need several appointments to confirm the diagnosis and figure out how serious your condition is. Your doctor should give you instructions before each visit on how you need to prepare for the other appointments.
Here's some information to help you get ready for your appointment, and to know what to expect from your doctor.
Preparing a list of questions will help you make the most of your time with your doctor. For Brugada syndrome, some basic questions to ask your doctor include:
Don't hesitate to ask any other questions you have.
Your doctor is likely to ask you a number of questions, such as: