> Incidentally, excuse my ignorance, but could you remind me
> about the Brugada syndrome again?!
Resting ECG usually shows ST elevation in V1- V2 and partial or complete
RBBB. Associated with fatal arrythmias, often exercise induced. (From a
sports medicine viewpoint, this is a more important part of the cardiac
screening than the possibly better known HOCM. Geneticists write all sorts
of clever stuff about gene loci that I can't remember. Unlike Arrythmogenic
Right Ventricular Dysplasia there is no structural abnormality, and the RBBB
is more a feature of Brugada syndrome that ARVD.
> It's just that our -
> admittedly slightly eccentric - lead cardiologist here
> believes that there are some "barn door" ECGs that he would
> have no problem accepting as representative of an MI,
> regardless of the clinical scenario.
And I'm sure he knows a lot more about it than us simple EPs do. For my own
part, I don't think I could be 100% certain on the basis of an ECG that
there had been a MI within the last 6 hours. You might be able to persuade
me that in the absence of contraindications there's a high enough
probability of benefit from thrombolysis that it's worth doing. But in a
case like this where there are a few major contraindications, I'm not so
sure of the risk: benefit.
Matt Dunn
Warwick
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