Healey Tiffany, Buckley Clifford, Mollman Matthew
Department of Emergency Medicine, Texas A&M University Health Science Center, College of Medicine, Baylor Scott and White Health, Central Texas Division, Temple, Texas.
J Emerg Med. 2017 Feb;52(2):227-230. doi: 10.1016/j.jemermed.2016.09.022. Epub 2016 Oct 14.
Brugada syndrome is a genetic disorder that increases an individual's risk for sudden cardiac death and ventricular dysrhythmias that was first described by the Brugada brothers in 1992. Brugada syndrome is characterized by an atypical electrocardiogram pattern that includes a bundle branch block and ST-segment elevation in the precordial leads.
A 74-year-old man had a cardiac arrest at the time of a low-speed motor vehicle collision. When emergency medical services arrived, the patient was in torsades de pointes. After resuscitation and return of spontaneous circulation, the patient was transferred to a Level I trauma center. He was ultimately diagnosed with Brugada syndrome after exclusion of traumatic injuries. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Brugada syndrome is still considered a "cannot miss" diagnosis in the emergency department, whether a patient presents with or without symptoms. In the mixed setting of trauma as a result of cardiac arrest, accurate diagnosis can be difficult due to the "chicken or the egg" dilemma.
布加综合征是一种遗传性疾病，会增加个体发生心源性猝死和室性心律失常的风险，该病于1992年由布加兄弟首次描述。布加综合征的特征是一种非典型心电图模式，包括束支传导阻滞和胸前导联ST段抬高。
一名74岁男性在低速机动车碰撞时发生心脏骤停。紧急医疗服务人员到达时，患者处于尖端扭转型室速状态。复苏并恢复自主循环后，患者被转至一级创伤中心。排除创伤性损伤后，他最终被诊断为布加综合征。急诊医生为何应了解这一情况？：在急诊科，无论患者有无症状，布加综合征仍被视为“不能漏诊”的疾病。在因心脏骤停导致创伤的混合情况下，由于“先有鸡还是先有蛋”的困境，准确诊断可能会很困难。
