Unexplained syncope, Brugada-like ECG and minimal structural right ventricular abnormalities: Which is the right diagnosis?

Department of Cardiology, Santa Maria dei Battuti Hospital, Conegliano, Italy.
Journal of Cardiovascular Medicine (Impact Factor: 1.51). 04/2009; 10(3):273-5. DOI: 10.2459/JCM.0b013e328322fc09
Source: PubMed


We describe a 65-year-old man with unexplained syncope, Brugada ECG pattern and right ventricular abnormalities. To reach a diagnosis of Brugada syndrome, a variety of diseases have to be excluded. This case report shows how difficult the differential diagnosis is, particularly with arrhythmogenic right ventricular cardiomyopathy, after documentation of minimal structural RV abnormalities; invasive examination may be required. In this case, three-dimensional electroanatomical bipolar voltage mapping revealed a scar area in the right ventricle in the absence of clear-cut kinetic abnormalities, but the sensitivity of this method and specificity in patients without confirmed arrhythmogenic right ventricular cardiomyopathy have not been defined.

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