Scenario: This 12-lead electrocardiogram (ECG) is from a 53-year-old Asian man who came to the emergency department (ED). He had just finished landscaping work on an extremely hot day when he had dizziness and complained of feeling like he was going to pass out. The patient had never experienced this before, so he called 911. In the ambulance, his blood pressure was 98/67 mm HG, heart rate 95 beats/min, and his temperature was 100.1°F. A liter of intravenous fluids was administered to treat dehydration and lower his body temperature. He was otherwise healthy and not taking any medications.

On ED admission, the ECG showed sinus bradycardia with ST segment changes in the septal precordial leads resembling features of Brugada syndrome (BrS).

Brugada syndrome is a genetic arrhythmic disorder caused by cardiac sodium-channel mutations. Patients with BrS are at risk for sudden cardiac death from ventricular fibrillation (VF); however, most...

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