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BACKGROUND:Declining cardiovascular mortality rates have been well-documented, yet temporal trends of suddencardiacdeath (SCD) in young individuals remain unclear.
A few decades ago all suddencardiacarrests with documented ventricular fibrillation (VF) and structurally normal hearts were diagnosed as idiopathic ventricular fibrillation (IVF).
Brugada syndrome is thought to account for about one fourth of suddencardiacdeaths in individuals with structurally normal heart. Even though mutations in other channels have been described in Brugada syndrome, only those in SCN5A gene are considered to be definitely disease causing. mV or R/q ≥ 0.75.
This discussion comes from this previous post: Hyperthermia and ST Elevation Discussion Brugada Type 1 ECG changes are associated with suddencardiacdeath (SCD) and the occurrence of ventricular dysrhythmias. See more cases of Brugada due to fever here. Heart Rhythm, 15(9): 1394-1401. [7]
The limb lead abnormalities appear to be part of the Brugada pattern, as described in this article: Inferior and Lateral Electrocardiographic RepolarizationAbnormalities in Brugada Syndrome Discussion Brugada Type 1 ECG changes are associated with suddencardiacdeath (SCD) and the occurrence of ventricular dysrhythmias.
Thus, Brugada is the likely diagnosis _ A very nice explanation of this is given in the document quoted below on current ECG criteria for Brugada pattern. Further history later: This patient personally has no further high risk features (syncope / presyncope), but her mother had suddencardiacarrest in sleep. months).
Unexplained cardiacarrest or documented VF/polymorphic VT: +3 3. Unexplained suddencardiacdeath (3 categories) (+0.5 - +2) 4. Cardiacarrest. Clinical History 2.a. of atrial fib/flutter at age less than 30: +0.5 syncope of unclear etiology: +1 2.c. Suspected arrhythmic syncope: +2 2.d.
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