Motor Vehicle Collision Secondary to Ventricular Dysrhythmia: A Case Report of Brugada Syndrome.

BACKGROUND: Brugada syndrome is a genetic disorder that increases an individual's risk for sudden cardiac death and ventricular dysrhythmias that was first described by the Brugada brothers in 1992. Brugada syndrome is characterized by an atypical electrocardiogram pattern that includes a bundle branch block and ST-segment elevation in the precordial leads.

CASE REPORT: A 74-year-old man had a cardiac arrest at the time of a low-speed motor vehicle collision. When emergency medical services arrived, the patient was in torsades de pointes. After resuscitation and return of spontaneous circulation, the patient was transferred to a Level I trauma center. He was ultimately diagnosed with Brugada syndrome after exclusion of traumatic injuries. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Brugada syndrome is still considered a "cannot miss" diagnosis in the emergency department, whether a patient presents with or without symptoms. In the mixed setting of trauma as a result of cardiac arrest, accurate diagnosis can be difficult due to the "chicken or the egg" dilemma.