Recurrent syncope: an unusual presentation of Brugada syndrome

Background A 55-year-old man presented at hospital with recurrent syncope. He did not have any prodromic symptoms and did not report having palpitations, dizziness or chest pain before, during or after the syncopal episodes. He had no family history of either syncope or sudden cardiac death. The patient was initially diagnosed with carotid sinus hypersensitivity and received a dual-chamber, rate-modulated pacemaker. Several months later, he presented at hospital again having had two more syncopal episodes. Investigations Physical examination, electrocardiography, echocardiography, cerebral CT scan, and carotid sinus massage. Diagnosis Syncope associated with Brugada syndrome. Management Implantation of a cardioverter-defibrillator.