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Brugada Syndrome — RACP Adult Medicine MCQ

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ModerateCardiologyBrugada SyndromeRACP Adult Medicine

A 25-year-old man presents with acute chest pain. ECG shows 2 mm ST elevation in V1–V3 with a coved morphology (type 1 pattern). He has no coronary risk factors. His father died suddenly aged 35. What is the diagnosis?

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Correct answer: E — Brugada syndrome

A type 1 Brugada pattern (coved ST elevation ≥2 mm followed by negative T wave in ≥1 right precordial lead V1–V3) with a family history of sudden cardiac death is diagnostic of Brugada syndrome. It is a genetic channelopathy (most commonly SCN5A sodium channel mutation) causing VF and sudden death. Risk stratification with EPS and clinical history guides ICD implantation. Fever, drugs (flecainide, procainamide, TCAs, cocaine), and electrolyte abnormalities can unmask or worsen the pattern. Family screening is essential.

Reference: eTG – 2025 – Cardiovascular; ESC – 2022 – Ventricular Arrhythmia Guidelines