Brugada syndrome awareness

Overview

Brugada syndrome is a rare heart condition that affects the way your heart's electrical signals work. This can increase the risk of dangerous heart rhythms (called arrhythmias) and sudden cardiac arrest. It is often inherited, meaning it runs in families.

No, Brugada syndrome is rare. It is estimated to affect about 1 in 2,000 to 5,000 people worldwide. It is more common in people of Asian descent.

Brugada syndrome can affect anyone, but it is more commonly diagnosed in adult men than in women. Symptoms often start in the 30s or 40s, but it can be present from childhood.

Symptoms

Common symptoms

• Fainting (syncope) without warning
• Palpitations or a feeling of a racing heart
• Seizures (caused by lack of blood flow to the brain)
• Sudden cardiac arrest (the heart stops beating properly)

Symptoms in children

• Fever can trigger symptoms in children with Brugada syndrome.
• Unexplained fainting or seizure-like episodes during a fever.
• Symptoms may be more subtle, such as tiredness or chest discomfort.

Symptoms in older adults

• Older adults may still experience fainting or palpitations.
• They may also have symptoms triggered by certain medications or alcohol.
• Sudden cardiac arrest remains a risk, especially during rest or sleep.

Causes

Main causes

• Brugada syndrome is usually caused by a change (mutation) in genes that control the heart's electrical activity. The most common is the SCN5A gene.
• It is inherited in an autosomal dominant pattern, meaning one copy of the altered gene from either parent can cause the condition.
• In some cases, no genetic cause is found.

Risk factors

• Having a parent or sibling with Brugada syndrome.
• Being male and of Asian descent.
• A history of unexplained fainting or cardiac arrest in the family.
• Certain triggers like fever, alcohol, or specific medicines (talk to your doctor).

When to see a doctor

See a doctor urgently if:

• If you have fainted without warning or had a seizure.
• If you have a family history of Brugada syndrome and experience palpitations or chest pain.
• If you or your child has a fever and a known Brugada diagnosis.

Book a routine appointment if:

• If you have a family member diagnosed with Brugada syndrome, even if you feel fine.
• If you are thinking about having children and have a family history of the condition.
• If you experience occasional palpitations or lightheadedness.

Diagnosis

Brugada syndrome is diagnosed using an electrocardiogram (ECG), which records the heart's electrical activity. A specific pattern on the ECG can suggest Brugada syndrome.

Tests that may be done

• Electrocardiogram (ECG) – a quick, painless test.
• Halter monitor – a portable ECG worn for 24-48 hours to catch irregular rhythms.
• Provocative testing with a medication (sodium channel blocker) given under medical supervision to reveal the ECG pattern.
• Genetic testing to look for gene mutations.

What to expect at your appointment

If your doctor suspects Brugada syndrome, you may be referred to a heart specialist (cardiologist). They will review your history, family history, and perform an ECG. Sometimes the ECG is normal at first, and further testing is needed. It is important to discuss all results with your doctor.

Treatment

Treatment focuses on preventing dangerous heart rhythms and reducing the risk of sudden cardiac arrest. Not everyone with Brugada syndrome needs treatment – it depends on your symptoms and risk level.

Self-care at home

• Avoid triggers that can worsen the condition, such as heavy alcohol use and large meals that cause a rapid drop in body temperature.
• Treat fevers promptly with fever-reducing measures like paracetamol (acetaminophen) – but always follow your doctor's advice.
• Tell your doctor about all medications you take, as some can worsen the condition.

Medical treatments

For people at high risk (those with fainting or a family history of cardiac arrest), doctors often recommend an implantable cardioverter-defibrillator (ICD). This small device is placed under the skin and monitors the heart. If a dangerous rhythm occurs, it delivers an electrical shock to restore normal rhythm. Some people may also be prescribed medications to control heart rhythms, but these are not suitable for everyone.

When is surgery considered?

Surgery is not a standard treatment for Brugada syndrome itself. The main procedure is implanting an ICD, which is minor surgery but not open-heart surgery.

Living with this condition

Living with Brugada syndrome means staying aware of your condition and following your doctor's recommendations. You may need to avoid certain triggers and always carry an emergency contact card. Most people can lead full, active lives with proper management.

Lifestyle tips

• Avoid excessive alcohol and stay hydrated.
• Manage stress with relaxation techniques like deep breathing or meditation.
• Stay active with moderate exercise, but talk to your doctor before starting any intense workouts.
• Wear a medical alert bracelet or carry a card stating you have Brugada syndrome.

Diet and exercise

A heart-healthy diet rich in fruits, vegetables, and whole grains is beneficial. Avoid very heavy meals that might trigger symptoms. Regular moderate exercise, such as walking or swimming, is usually safe. Check with your doctor before competitive sports or intense exercise.

Mental health and emotional wellbeing

Being diagnosed with a heart condition can be worrying. It is normal to feel anxious or stressed. Speak with your doctor about counseling or support groups. Taking an active role in your health can help you feel more in control.

Prevention

Brugada syndrome cannot be prevented because it is genetic. However, you can reduce your risk of complications by avoiding triggers, treating fevers early, and getting regular check-ups.

Vaccines

Vaccines are generally safe, but always inform your doctor about your Brugada syndrome before any vaccination. Fever from vaccines should be managed promptly.

Screening programmes

If you have a family history of Brugada syndrome, your doctor may recommend screening with an ECG and possibly genetic testing. Family screening can help identify others at risk.

Complications

If left untreated

• Sudden cardiac arrest, which can be fatal if not treated immediately.
• Fainting episodes that can lead to injury.
• Seizures caused by lack of blood flow to the brain.

Long-term outlook

With proper management, many people with Brugada syndrome live long, healthy lives. An ICD can be lifesaving. Advances in genetic testing and monitoring continue to improve outcomes. Your healthcare team will work with you to create a plan that fits your needs.

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