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Learning About Brugada Syndrome

The electrical system of the heart

What is Brugada syndrome?

Brugada syndrome is a rare problem with the heart's electrical system. This system controls the speed and rhythm of your heartbeat. Brugada syndrome may cause your heartbeat to be very fast and abnormal. If this causes the heart to stop pumping blood normally, sudden death can happen. The syndrome often runs in families.

What causes it?

Brugada syndrome is caused by changes to some genes. These genes affect the electrical system that controls your heartbeat. If you have the syndrome, a fast and abnormal heartbeat can be set off when you use certain medicines, too much alcohol, or cocaine. It can also happen when you have a fever.

What are the symptoms?

Symptoms happen because the heart beats too fast. It can't pump enough blood to the rest of the body.

Symptoms include:

  • Fainting.
  • Palpitations. This is an uncomfortable feeling that your heart is beating too fast or with an abnormal rhythm. You might feel pounding or fluttering in your chest. Or you may feel like your heart skips a beat.
  • Chest pain and pressure.
  • Sudden gasping. This most often happens at night.
  • Sudden cardiac arrest. This means that the heart suddenly stops beating.

How is it diagnosed?

Your doctor will do an electrocardiogram (ECG or EKG). It shows your heart's electrical activity as line tracings on paper. People with the syndrome have a certain pattern to their heartbeat. Your doctor can see the pattern on the tracing. Some people are brought to the hospital for a special ECG done during a medication infusion.

Sometimes the test doesn't show the pattern. If your doctor thinks you have Brugada syndrome, you may be given medicine before you have another EKG. The medicine can bring out the abnormal heartbeat during the test. This way the pattern can be seen on the tracing.

Your doctor may do tests to check for other heart diseases. The doctor will do a physical exam and ask about your symptoms and past health. The doctor may also ask if family members have symptoms or have been diagnosed with the syndrome. The doctor may also ask if any family members died suddenly and without warning. You may have a genetic test.

How is it treated?

The goal of treatment is to keep your heart beating normally and help improve symptoms. It's also to prevent sudden death.

Your doctor might prescribe medicines. They can help control your heart's rhythm.

Your doctor may suggest a device called an ICD (implantable cardioverter-defibrillator). It can detect an abnormal heartbeat and help bring back a normal rhythm. It is placed in the chest with minor surgery.

How can you care for yourself?

You can take steps to protect yourself from having an abnormal heart rhythm.

  • Tell your doctors and pharmacist about your condition.

    They can help you avoid medicines that can start a fast or abnormal heartbeat. These include some drugs for heart conditions and some antidepressants.

  • If you drink alcohol, try to drink less.

    Your risk of harm from alcohol is low if you have 2 drinks or less per week. Work with your doctor to find what is right for you.

  • Treat a fever right away.

    Use medicines that reduce fever. These include ibuprofen, aspirin, and acetaminophen.

  • Don't use cocaine.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

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