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Broad or Wide Complex Regular QRS Monomorphic Ventricular Tachycardia in young man with spontaneous Type 1 ECG Brugada pattern

Dr. Raimundo Barbosa Barros
Dr. Raimundo Barbosa Barros
Brazil

Case presentation

Male, 33-year-old patient (previously healthy) was admitted into the emergency room with oppressive chest pain. Hemodynamically stable.
Negative family history.

He did not use any medication or illegal drugs. No previous syncope. No fever during ECG recordings.

The physician interpreted the initial ECG as Supraventricular Tachycardia with aberrancy (SVT-A) and he administered adenosine injection, unsuccessfully.
Later, 50 J electrical cardioversion was conducted, which led to VF and a short while later 200 J defibrillation was applied, successfully.

Normal troponin and electrolyte levels.

The patient was moved to the Hospital, where coronary angiography was performed (normal). Normal echo.

Questions:

  1. What is the diagnosis of ECG-1 and why?
  2. What is the diagnosis of ECG-2 registered immediately after electrical cardioversion?
  3. What is the diagnosis of ECG-3 performed after coronary angiography than normal result?
  4. What is diagnostic ECG-4 performed 24 hours after admission?
  5. What is the diagnosis ECG-5 performed 72 hours after being asymptomatic admission with high right precordial V1H V2H
  6. Can this patient be carrying the Brugada syndrome with monomorphic TV?

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Auspicios Institucionales
  • Sociedad Argentina de Cardiología
  • Federación Argentina de Cardiología
  • SIAC
  • SADEC
  • Asociación Argentina de Cardiología
  • Latin American Heart Rhythm Society
  • Fundación Barceló - Facultad de Medicina