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Which of the following is not true about Brugada syndrome

A
SCN5A defect
B
Asymptomatic ST segment elevation
C
Sudden death
D
Pacemaker is the treatment of choice
High-Yield Explanation
Brugada syndrome (BrS) is a genetic disorder in which the electrical activity within the hea is abnormal. It increases the risk of abnormal hea rhythms and sudden cardiac death. Diagnosis is typically by electrocardiogram (ECG), however, the abnormalities may not be consistently present. About a quaer of those with Brugada syndrome have a family member who also has the condition.Some cases may be due to a new genetic mutation or ceain medications. The most commonly involved gene is SCN5A which encodes the cardiac sodium channel.Diagnosis is typically by electrocardiogram (ECG), however, the abnormalities may not be consistently present.Medications such as ajmaline may be used to reveal the ECG changes.Similar ECG patterns may be seen in ceain electrolyte disturbances or when the blood supply to the hea has been reduced. There is no cure for Brugada syndrome.Those at higher risk of sudden cardiac death may be treated using an implantable cardioveer defibrillator (ICD) In those without symptoms the risk of death is much lower, and how to treat this group is less clear. Isoproterenol may be used in the sho term for those who have frequent life-threatening abnormal hea rhythms, while quinidine may be used longer term.Testing people's family members may be recommended While many of those with Brugada syndrome do not have any symptoms, Brugada syndrome may cause fainting or sudden cardiac death due to serious abnormal hea rhythms such as ventricular fibrillation or polymorphic ventricular tachycardia.Blackouts may be caused by brief abnormal hea rhythms that reve to a normal rhythm spontaneously. If a dangerous hea rhythm does not stop by itself and is left untreated, the person may have a fatal cardiac arrest. However, blackouts can occur in those with Brugada syndrome despite a normal hea rhythm due to a sudden drop in blood pressure, known as vasovagal syncope. The abnormal hea rhythms seen in Brugada syndrome often occur at rest, following a heavy meal, or even during sleep.These situations are linked to periods when the vagus nerve is activated, referred to as periods of high vagal tone. Abnormal hea rhythms may also occur during fever or following excessive alcohol. Ceain medications may also worsen the tendency to abnormal hea rhythms in patients with Brugada syndrome and should be avoided by these patients. Ref Davidson 23rd edition pg 440

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