Welman Kiera, Matloob Samir, Dubrey Simon William, Elliott Perry
Cardiology Department, Hillingdon Hospital, Uxbridge, Middlesex, UK.
BMJ Case Rep. 2011 Aug 31;2011:bcr0620114418. doi: 10.1136/bcr.06.2011.4418.
A Brugada pattern on routine electrocardiography is one of several features that can indicate the potential for life threatening rhythm disturbances. The authors describe such a scenario in an asymptomatic 38-year-old woman who required significant surgery under anaesthesia. The diagnosis and possible management routes are outlined with an emphasis on the incumbent psychosocial and familial issues that are encountered. The patient underwent her surgery and was then further investigated to 'prove' the diagnosis. Ultimately, the patient declined further investigations and interventions. This case highlights the dilemma faced by anaesthetists and clinicians, not to mention the patients and their family when a Brugada phenotype is identified on a routine ECG. Clinicians should seek an expert opinion but ultimately, as in this case, the patient should be positioned to make an informed decision on what route to follow.
常规心电图上的Brugada波型是提示潜在危及生命的心律失常可能性的几种特征之一。作者描述了一名38岁无症状女性的此类情况，该女性需要在麻醉下进行重大手术。文中概述了诊断及可能的处理途径，重点强调了所遇到的相关社会心理和家庭问题。患者接受了手术，随后进行了进一步检查以“证实”诊断。最终，患者拒绝了进一步检查和干预。该病例凸显了麻醉医生和临床医生所面临的困境，更不用说当在常规心电图上识别出Brugada表型时患者及其家人所面临的困境了。临床医生应寻求专家意见，但最终，就像在这个病例中一样，应让患者能够在后续采取何种途径方面做出明智的决定。
