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Brugada syndrome — RACP Adult Medicine MCQ

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HardCardiologyBrugada syndromeRACP Adult Medicine

A 32-year-old man is assessed after nocturnal syncope. His brother died suddenly during sleep. ECG shows coved ST elevation in V1-V2 with T-wave inversion, accentuated during fever. Echocardiography is structurally normal. What is the most likely cause?

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Correct answer: A — Inherited cardiac sodium-channel dysfunction

The ECG pattern and nocturnal syncope indicate Brugada syndrome, commonly related to sodium-channel dysfunction. Coronary plaque rupture would produce an ischaemic presentation, and rheumatic valve disease or shunt physiology would usually be structural. Myocarditis can cause arrhythmia but does not classically produce this fever-sensitive right precordial pattern.

Reference: CSANZ inherited arrhythmia guidance; AMH