Brugada syndrome differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Abnormalities that can lead to ST-segment elevation in the right precordial leads include the following:

• Acute myocardial ischemia or infarction
• Acute myocarditis
• Acute pulmonary thromboemboli
• Arrhythmogenic right ventricular dysplasia / cardiomyopathy (ARVD/C)
• Cocaine intoxication
• Dissecting aortic aneurysm
• Duchenne muscular dystrophy
• Friedreich ataxia
• Heterocyclic antidepressant overdose
• Hypercalcemia
• Hyperkalemia
• Hypothermia, causing Osborn wave in ECGs and sometimes resembling Brugada syndrome
• Left ventricular hypertrophy
• Mediastinal tumor compressing the right ventricular outflow tract (RVOT)
• Right or left bundle-branch block
• Right ventricular infarction
• Right ventricular ischemia
• Thiamine deficiency
• Various central and autonomic nervous system abnormalities

• Other conditions that can lead to ST-segment elevation in the right precordial leads

• Early repolarization syndrome
• Other normal variants (particularly in males)