Teo W S, Kam R, Tan R S, Maglana M, Lim Y L
Department of Cardiology, Singapore Heart Centre, Singapore.
Int J Cardiol. 1998 Aug;65(3):281-6. doi: 10.1016/s0167-5273(98)00137-5.
Sudden cardiac death has been reported in patients with a unique electrocardiographic (ECG) abnormality showing right bundle branch block and ST segment elevation in the precordial leads. This syndrome was first described by Brugada and Brugada and has not been previously described in a Chinese population. We report here the first three cases in Singapore. The first patient was a 49-year-old man who presented with syncope, associated with generalized convulsions. The second patient was a 25-year-old man who complained of palpitations but no syncope. The third patient was a 77-year-old man who presented with recurrent episodes of syncope and collapsed with ventricular fibrillation. All patients had no past cardiac or drug history of note. The neurological examination and investigations were normal. All three patients showed a unique right bundle branch block pattern with ST segment elevation in leads V1-3. The echocardiogram and 24-h ambulatory ECG monitoring, were normal. Single vessel disease was present in the third patient. Electrophysiological studies performed in all three patients were able to induce ventricular fibrillation. The patient with resuscitated cardiac death underwent an implantable cardioverter defibrillator implantation. The importance of this syndrome is that the recognition of the unique ECG pattern enables early identification and treatment of these patients.
据报道，患有一种独特心电图（ECG）异常的患者会发生心源性猝死，该异常表现为右束支传导阻滞和胸前导联ST段抬高。这种综合征最初由Brugada和Brugada描述，此前尚未在中国人群中报道过。我们在此报告新加坡的首例三例病例。首例患者是一名49岁男性，表现为晕厥，并伴有全身性抽搐。第二例患者是一名25岁男性，主诉心悸但无晕厥。第三例患者是一名77岁男性，表现为反复发作的晕厥，并因室颤而跌倒。所有患者既往均无显著的心脏或用药史。神经学检查及相关检查均正常。所有三例患者均表现出独特的右束支传导阻滞模式，V1-3导联ST段抬高。超声心动图及24小时动态心电图监测均正常。第三例患者存在单支血管病变。对所有三例患者进行的电生理研究均能诱发室颤。心源性猝死复苏的患者接受了植入式心脏复律除颤器植入术。该综合征的重要性在于，识别独特的心电图模式能够早期识别并治疗这些患者。
