Key result
CPET unmasks type I Brugada syndrome in a highly trained athlete.
Case Report (n=1)
No
Highlights an unusual presentation of Brugada syndrome in an elite athlete unmasked by high-intensity training and ergospirometry, leading to guideline-directed cessation of competition.
CPET warrants consideration in symptomatic athletes; this case report leaves broader screening utility open.
Brugada syndrome is a type of arrhythmia characterized by an abnormal electrocardiogram (ECG) and an increased risk of sudden cardiac death in athletes and active recreationists. The most common sign is persistent ST elevation in ECG leads from V1-V3 with right branch block (RBBB). We presented the case of a mixed martial arts (MMA) fighter who, only at the age of 35, after increasing the intensity of training, felt fatigued, drowsiness and a drop in blood pressure to 90/60 mmHg in his recovery and at home, with the persistence of tachycardia up to 110 /min. There was no syncope. The ECG showed a sinus rhythm, 62 beats /min, RBBB with suspected ST elevation in the V1 to V3 leads. The echo of the heart was completely normal as was the magnetic resonance imaging of the heart. Ergospirometry was performed and the peak oxygen consumption was 42 ml/kg/min, which indicates high functional abilities. However, the ECG showed a typical picture of type I Brugada syndrome thus confirming the diagnosis. In accordance with the recommendations, it is advisable to stop training and competition.
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Nedeljković et al. (2021) conducted a case report in Brugada syndrome (n=1). Cardiopulmonary exercise test (CPET) vs. null was evaluated on saddle elevation of the ST segment in the V1 and V2 leads during CPET. The case highlights the importance of CPET in unmasking type I Brugada syndrome in a highly trained athlete.
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