Syncope in a Young Man

Abstract

Introduction: Syncope is a common complaint in the emergency department, accounting for 1%–3% of all visits and hospitaladmissions. Most causes are often benign and self-limited allowing safe discharge. However, others, particularly those resultingfrom cardiac syncope, are associated with significant morbidity and mortality. An electrocardiogram (ECG) is essential in additionto clinical history and physical examination for risk stratification. It is useful for identifying patients with inherited syndromesthat predispose them to cardiac arrhythmias.Case Report: We report a case of a young man who presented with syncope to the emergency department. He wasasymptomatic on arrival, but subsequently developed seizures secondary to ventricular fibrillation that required defibrillation.His initial ECG revealed characteristics of type 1 Brugada syndrome. The patient was fitted with an internal cardiac defibrillatorand was discharged. We discuss the presentation, pathophysiology, and management of patients with Brugada syndrome.Conclusion: In patients presenting with syncope, ECG is essential for risk stratification and identifying patients with possibleinherited syndromes. A high index of suspicion is necessary for diagnosing.