Rationale: Brugada syndrome (BrS) is a cardiac ion channel disease that is caused by an autosomal
dominant genetic abnormality. It is frequently seen among young and middle-aged adults of Asian descent
and rarely in blacks.
Patient Concerns: We report an extremely rare case of an 82-year-old male known hypertensive with poor
drug compliance, who suffered recurrent palpitations and pre-syncope. His electrocardiogram showed an
unusual right bundle branch block with coved ST segment elevation in leads V1-V3.
Diagnoses: The patient was eventually diagnosed with Brugada Syndrome with background hypertensive
heart disease. He could not have genetic testing due to unavailability and cost.
Interventions: The patient was treated with antihypertensives but could not afford a device implant. He
was counseled to avoid risk factors such as fever, extreme physical and emotional exertions etc.
Outcomes: At his last clinic visit two months post diagnosis he still had similar symptoms but no syncope
nor sudden cardiac arrest.
Lessons: To the best of our knowledge, this is possibly the first reported case of BrS in an elderly African
with hypertensive heart disease.
G004 Transcriptional profiling of ion channel genes in right-ventricular myocardial diseases: particular signature for brugada syndrome