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:[1]
- Acute myocardial ischemia or infarction
- Acute myocarditis
- Acute pericarditis
- Acute pulmonary thromboemboli
- Arrhythmogenic right ventricular dysplasia / cardiomyopathy (ARVD/C)[2][3]
- Cardioversion. Brugada-like ECG changes can be observed briefly after direct-current cardioversion. It is currently unclear if this is a sign that the patient is a gene carrier for Brugada syndrome.
- Cocaine intoxication
- Coronary spasm
- Dissecting aortic aneurysm[4]
- Duchenne muscular dystrophy[5]
- Early repolarization
- Friedreich ataxia
- Heterocyclic antidepressant overdose
- Hypercalcemia[6][7]
- Hyperkalemia[8][9][10]
- Hypothermia, can cause an Osborn wave on the ECG which can sometimes resemble Brugada syndrome[11][12]
- Left ventricular hypertrophy
- Pectus excavatum[13]
- Prinzmetal's angina[14]
- Mediastinal tumor compressing the right ventricular outflow tract (RVOT)
- Right (atypical) or left bundle-branch block
- Right ventricular infarction
- Right ventricular ischemia
- Right ventricular outflow tract compression due to a mediastinal tumor or hemopericardium
- Thiamine deficiency[15]
- 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)
References
- ↑ Takehara N, Makita N, Kawabe J, Sato N, Kawamura Y, Kitabatake A, Kikuchi K (2004). "A cardiac sodium channel mutation identified in Brugada syndrome associated with atrial standstill". Journal of Internal Medicine. 255 (1): 137–42. PMID 14687250. Retrieved 2012-10-13. Unknown parameter
|month=ignored (help) - ↑ Corrado D, Nava A, Buja G, Martini B, Fasoli G, Oselladore L, Turrini P, Thiene G. Familial cardiomyopathy underlies syndrome of right bundle branch block, ST segment elevation and sudden death. J Am Coll Cardiol. 1996; 27: 443–448.
- ↑ Corrado D, Basso C, Buja G, Nava A, Rossi L, Thiene G. Right bundle branch block, right precordial ST-segment elevation, and sudden death in young people. Circulation. 2001; 103: 710–717.
- ↑ Myers GB. Other QRS-T patterns that may be mistaken for myocardial infarction; IV. Alterations in blood potassium; myocardial ischemia; subepicardial myocarditis; distortion associated with arrhythmias. Circulation. 1950; 2: 75–93.
- ↑ Perloff JK, Henze E, Schelbert HR. Alterations in regional myocardial metabolism, perfusion, and wall motion in Duchenne muscular dystrophy studied by radionuclide imaging. Circulation. 1984; 69: 33–42.
- ↑ Douglas PS, Carmichael KA, Palevsky PM (1984). "Extreme hypercalcemia and electrocardiographic changes". The American Journal of Cardiology. 54 (6): 674–5. PMID 6475795. Unknown parameter
|month=ignored (help);|access-date=requires|url=(help) - ↑ Sridharan MR, Horan LG (1984). "Electrocardiographic J wave of hypercalcemia". The American Journal of Cardiology. 54 (6): 672–3. PMID 6475794. Unknown parameter
|month=ignored (help);|access-date=requires|url=(help) - ↑ Myers GB. Other QRS-T patterns that may be mistaken for myocardial infarction; IV. Alterations in blood potassium; myocardial ischemia; subepicardial myocarditis; distortion associated with arrhythmias. Circulation. 1950; 2: 75–93.
- ↑ Merrill JP, Levine HD, Somerville W, Smith S. Clinical recognition and treatment of acute potassium intoxication. Ann Intern Med. 1950; 33: 797–830.
- ↑ Ortega-Carnicer J, Benezet J, Ruiz-Lorenzo F, Alcázar R (2002). "Transient Brugada-type electrocardiographic abnormalities in renal failure reversed by dialysis". Resuscitation. 55 (2): 215–9. PMID 12413761. Retrieved 2012-10-13. Unknown parameter
|month=ignored (help) - ↑ Osborn JJ. Experimental hypothermia; respiratory and blood pH changes in relation to cardiac function. Am J Physiol. 1953; 175: 389–398.
- ↑ Noda T, Shimizu W, Tanaka K, Chayama K (2003). "Prominent J wave and ST segment elevation: serial electrocardiographic changes in accidental hypothermia". Journal of Cardiovascular Electrophysiology. 14 (2): 223. PMID 12693512. Retrieved 2012-10-13. Unknown parameter
|month=ignored (help) - ↑ Kataoka H. Electrocardiographic patterns of the Brugada syndrome in right ventricular infarction/ischemia. Am J Cardiol. 2000; 86: 1056.
- ↑ Wang K, Asinger RW, Marriott HJ (2003). "ST-segment elevation in conditions other than acute myocardial infarction". The New England Journal of Medicine. 349 (22): 2128–35. doi:10.1056/NEJMra022580. PMID 14645641. Retrieved 2012-10-13. Unknown parameter
|month=ignored (help) - ↑ Read DH, Harrington DD (1981). "Experimentally induced thiamine deficiency in beagle dogs: clinical observations". American Journal of Veterinary Research. 42 (6): 984–91. PMID 7197132. Unknown parameter
|month=ignored (help);|access-date=requires|url=(help)