What is Brugada Syndrome?
Brugada Syndrome is a rare, genetic heart condition that affects the heart’s electrical system. It increases the risk of dangerous, irregular heart rhythms (arrhythmias), particularly ventricular fibrillation, which can lead to sudden cardiac death.
During ventricular fibrillation, the heart cannot pump blood effectively, and without prompt intervention, this can lead to cardiac arrest and sudden death. What makes Brugada syndrome particularly dangerous is that symptoms typically occur during sleep or rest and often without obvious warning signs.
Brugada syndrome is typically associated with mutations in the SCN5A gene and causes abnormalities in the sodium channels of heart muscle cells. This disrupts the heart’s electrical activity, triggering arrhythmias. Risk factors include genetic predisposition, fever, alcohol consumption, stress, and certain medications. Brugada syndrome is more common in men than women and typically appears at a young age.
What are the Symptoms of Brugada Syndrome?
Brugada syndrome usually doesn’t give noticeable symptoms and is often detected incidentally during an ECG. However, some patients may experience the following symptoms:
- Irregular heartbeats (palpitations)
- Fainting (during ventricular arrhythmia episodes)
- Dizziness
- Abnormal breathing, wheezing, or chest discomfort during the night
- Sweating
- Sudden cardiac arrest
- Characteristic changes in ECG
What Causes Brugada Syndrome?
Brugada syndrome is a genetic heart condition, and its most common cause is mutations in the SCN5A gene. This gene ensures proper functioning of sodium channels responsible for conducting electrical signals in the heart. This genetic disorder in sodium channels causes electrical activity to become irregular in the right ventricle. As a result, serious arrhythmias such as ventricular tachycardia and ventricular fibrillation may occur.
While genetic predisposition is the primary cause of Brugada syndrome, environmental factors also play an important role. Conditions such as fever, certain medications, electrolyte imbalances, and increased vagal tone can trigger this syndrome. Brugada syndrome is a rare condition. It can occur in 3 to 5 out of every 10,000 people. It is 8-10 times more common in men than women.
Brugada Syndrome Risk Factors:
The main factors that increase the risk of developing Brugada syndrome are:
- Gender: More common in men than women
- Race: Higher prevalence particularly in individuals of Asian descent
- Genetic predisposition: Higher risk in individuals with family history of Brugada syndrome
- Fever: High fever can trigger arrhythmias by further disrupting sodium channel function
- Certain medications: Some drugs like anti-arrhythmics, antidepressants, or anesthetics can trigger Brugada syndrome
- Electrolyte imbalances: Low potassium, calcium, or magnesium levels can worsen the condition
- Increased vagal tone: Increased vagal tone during sleep or rest can affect heart rhythm
- Alcohol and illegal substance use: Alcohol and substances like cocaine can worsen the course of the disease by triggering arrhythmias
- Age: Usually diagnosed in middle age, but can appear in childhood or young adulthood
What Should People with Brugada Syndrome Be Careful About?
Patients with Brugada syndrome should pay attention to these lifestyle changes:
- Quickly reducing fever when it occurs
- Avoiding medications that can affect rhythm
- Limiting alcohol consumption
- Maintaining regular sleep patterns
- Having regular doctor check-ups
How is Brugada Syndrome Diagnosed?
Brugada syndrome is usually diagnosed through ECG (Electrocardiogram). This test, which records electrical activities in the heart, detects specific abnormalities particularly in certain areas (right chest leads). This abnormality sometimes appears spontaneously, but in some cases, testing with special medications may be necessary.
Genetic tests can be performed to confirm the diagnosis. Additionally, a Holter device (24-hour heart monitor) may be needed to understand how frequently arrhythmias occur, or electrophysiological study for more detailed evaluation.
How is Brugada Syndrome Treated?
While there is no complete cure for Brugada syndrome, various approaches are used to prevent sudden cardiac arrest. ICD (Implantable Cardioverter Defibrillator) implantation is life-saving for high-risk patients. This device detects dangerous arrhythmias and restores normal rhythm by delivering electrical shocks. Rapid fever reduction, avoiding trigger medications, and regular cardiological follow-up are important for all patients. Antiarrhythmic drugs like quinidine may be beneficial in some patients. Screening family members and genetic counseling are critical for early diagnosis and treatment of the condition.
Conclusion: Risk Can Be Reduced with Early Diagnosis and Regular Check-ups
Early diagnosis and regular check-ups are critical in reducing the risks of Brugada syndrome. Patients receiving appropriate treatment can safely continue their lives. If there is a family history of sudden cardiac arrest or if symptoms appear, a cardiology specialist should be consulted.
Reference: Brugada Syndrome