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Brugada syndrome — SCE Acute Medicine MCQ

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HardAcute Cardiac PresentationsBrugada syndromeSCE Acute Medicine

A 51-year-old woman presents with acute chest symptoms with haemodynamic concern. Relevant history includes cardiovascular risk factors or structural heart disease. On assessment, haemodynamic findings and ECG changes are present. Investigations show syncope with coved ST elevation in V1 to V3 and family sudden death. What is the most likely diagnosis?

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Correct answer: E — Brugada syndrome

The key discriminator is that syncope with coved ST elevation in V1 to V3 and family sudden death, which makes Brugada syndrome the single best answer. Acute pancreatitis is less appropriate because it does not address the dominant acute risk in the vignette; Pulmonary embolism would fit a different presentation or later stage of care. Bacterial meningitis and Toxic drug ingestion are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: https://www.nice.org.uk/guidance#acute-medicine-order-98-1