Brugada syndrome is a form of a heart disorder consisting of the manifestation of an irregular rhythm of the heartbeat. The disruption of the normal heart rhythms is caused by the uncoordinated electrical activities that are taking place from the chambers of the heart called the ventricles. The abnormal rhythms in the ventricles are called ventricular arrhythmia. Brugada syndrome can become a life threatening disease because cardiac arrest and eventually death may occur. What makes the condition more dangerous is its being asymptomatic, which makes the victims unaware they have the condition. While the disease can be serious, it is highly preventable by avoiding common triggers of the condition such as certain medications and preventive implants like the implantable cardioverter defibrillator.
Who are susceptible to Brugada Syndrome?
About 5 out of 10,000 people are at risk of the condition. Asians are known to be more at risk, especially the Japanese and those living in the Southeast Asian nations. Men are 10 times more susceptible to the disease than women and this is attributed to the testosterone levels that makes men more at risk of Brugada syndrome. The condition usually occurs during the adulthood, but it can rarely affect children and infants too. Sudden death accounts to the fatality of the disease which typically affects those at the age of 40 and older. Babies who died due to sudden infant death syndrome are believed to have Brugada syndrome which was not diagnosed.
Characteristics and features of Brugada syndrome
The classic feature of Brugada syndrome is sudden death. The ventricular arrhythmia occurs while the person is asleep and it accounts for most unexplained deaths. It is often associated with unexpected cardiac arrest in young adults while sleeping, which is a condition called sudden unexplained nocturnal death syndrome. Continuous research further confirmed that the sudden unexplained nocturnal death syndrome and the Brugada syndrome are the same disease.
Genetic links in Brugada syndrome
Genetic link involving the SCN5A gene is strong with Nrugada syndrome. Genetic mutation is found to be present among one third of the population affected by the disease. The mutation causes an abnormality in the activities of the sodium channel which is critically involved in maintaining normal heart rhythms. Consequential abnormalities in the sodium channels alter the amount of sodium flow to the heart cells, which interrupts the normal rhythm of the heart. To a certain extent, the heart eventually stops beating because of ventricular arrest.
Some medications are also believed to cause similar results which genetically occur with the abnormal genetic mutations. Drugs prescribed for angina among individuals with a heart disease can result in acquiring Brugada syndrome. This form of non-genetic Brugada syndrome is often induced by drugs that are taken for treating arrhythmia, high blood pressure and depression.
Warning signs of Brugada Syndrome
There are warning symptoms that may indicate that you have a Brugada syndrome. The common signs and symptoms of the disease include the following:
- Nightmares and thrashing at night
- Abnormal pattern of electrocardiogram (called type 1 Brugada ECG pattern)
- Fever that usually worsens the clinical symptoms
- Cardiac arrest
- Syncope or fainting
- Elevated ST segment in leads V1-V3
- Atrial fibrillation
The common reason why the Brugada syndrome is often under diagnosed is due to its asymptomatic feature. The symptoms may appear to take the form of other diseases, but it usually does not manifest any symptoms at all. The only accurate way of diagnosing the disease is through ECG.
Getting diagnosed for Brugada Syndrome
Detecting Brugada syndrome is difficult through physical examination. A thorough physical assessment to the patient will give normal results. A more thorough examination is needed in order to detect the disease and an ECG test will give provide a more accurate diagnosis. Whenever you experience palpitations and other signs of an irregular heartbeat, make sure to see your doctor immediately. Most individuals who experience fainting, cardiac arrhythmia or palpitations are quick to conclude that such may be a sign of a heart disease. However, Brugada syndrome is a deadlier disease than a heart disease that usually results in a sudden death. You can prevent this from happening unexpectedly by being mindful about your symptoms and report it to your doctor right away.
Treatment and management of Brugada Syndrome
There is currently no pharmacologic treatment for Brugada Syndrome. No medication has yet been discovered to cure and treat ventricular arrhythmias to prevent a sudden death. The only promising treatment and management of the disease is the automatic implantable defibrillator or ICD which is effective in preventing abnormal rhythms of the heart chambers. Individuals with at least two risk factors of Brugada syndrome are good candidates for the implantation of the ICD. It is usually prescribed for individuals with a genetic history of the disease and those already with heart disease.
Life saving response to Brugada syndrome
Because sudden death occurs with the disease, it is important to know how to respond in case someone has a ventricular arrhythmia attack. Sudden cardiac arrest occurs and the person may lose consciousness and experience a sudden loss of breathing. Without immediate medical attention, this can become fatal and may lead to death. Administering cardiopulmonary resuscitation can be a life saving response whenever a sudden cardiac arrest occurs. Giving the person with an external shock using an automatic external defibrillator can also help the victim survive.