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Pectus excavatum with spontaneous type 1 ECG Brugada pattern or Brugada like phenotype: another Brugada ECG phenocopy

Dr. Andrés R. Pérez Riera
Dr. Andrés R. Pérez Riera
Brazil

Case presentation

Young, male 19-year-old patient: asymptomatic, who presented at our office of an evaluation prior to the practice of sports.
Negative personal and family history for syncope or sudden death in first-degree relatives younger than 45 years old.
Physical examiantion: The visual or ectoscopic test of the chest, reveals very significant Pectus excavatum with the lower third of the sternum more affected than the higher third, which was virtually normal. He mentioned that such deformity was noticed since his birth, with a progressive worsening. No first-degree relative was a carrier of pectus excavatum, Marfan syndrome, or Poland syndrome.
Cardiac auscultation: mild systolic murmur ++ in pulmonary focus. No click in the mitral valve.
Lung sounds appear diminished at both bases.
The ECG revealed spontaneous type 1 Brugada-like pattern, and several of the typical elements of pectus excavatum: completely negative P wave in V1 and V2, qR pattern from V1 to V3, and right bundle branch pattern.
The echocardiogram was normal.
The X-Ray of PA chest showed a pseudo-increase of the cardiac area and lateral projection, significant decrease of the antero-posterior diameter of the chest. FUNCTIONAL RESPIRATORY TEST: Mild restrictive ventilatory disorder. The pulmonary volumes are reduced and there is reduction of total pulmonary capacity that indicates restrictive disorder (Mild restrictive ventilatory disorder.).

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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