Brugada syndrome : An unusual cause of syncope in a young patient

yncope is a sudden and transient loss of cons s sciousness associated with loss of postural tone from which recovery is spontaneous. 1The most common cause of syncope in the general population is neurocardiogenic followed by primary arrhythmias. 2In the presence of underlying heart disease, syncope is ass s sociated with a high rate of mortality.Sudden cardiac death (SCD) is a witnessed cardiac arrest within 1 hour after the onset of acute symptoms or unexpected, unswitnessed death in a patient known to have been well within the previous 24 hours. 3It ocs s curs with an approximate incidence of 1 per 1000 ins s habitants per year in the West. 4The leading cause of SCD is ventricular fibrillation secondary to either acute ischemic events or underlying structural heart disease.However, no identifiable cause could be found in 10% of these victims during autopsy or during extensive evaluation of surviving cases. 4rugada syndrome is a new clinical entity first des s scribed by Brugada and Brugada in 1992.5 This syns s drome is responsible for approximately 4% of all SCD and 20% of SCD in patients without structural heart disease.6 It is now considered an important cause of syncope among young patients. CaseA 19syearsold male laborer, previously healthy, presents s ed to our emergency department due to sudden loss of consciousness and falling down after emotional stress.This lasted for few seconds as described by his coms s panion who witnessed the event.There was a history of brief palpitation, but he denies any chest pain, shortness of breath or seizures.The patient retained consciouss s ness rapidly, without headache or confusion, but could not recall the event exactly.He reported no similar ats s tacks before, and had no family history of syncope, epis s lepsy, or sudden unexplained death.On examination the patient was a young, wellsbuilt and healthy male.His blood pressure was 137/82 mm