Male, 64-year-old patient, who was admitted with symptoms of chest pain typical of acute coronary syndrome.
• ECG (admission) shows a pattern of inferior AMI with RV compromise (confirmed by V4R) + second degree AVB, type I. Associate typical type 1 Brugada pattern in V1 lead. As there was no hemodynamic room available, the patient underwent fibrinolytic therapy with streptokinase (1 hour infusion).
• ECG (post STK) shows a pattern resembling that of a variant of Brugada Syndrome or atypical Brugada pattern: “Lambda like wave” in inferior leads.
• Later, the patient underwent coronary angiography, which showed critical residual lesion of proximal RCA, which in turn was treated with STENT implant.