Dallas Regional Makes Rare Diagnosis

Doctors at Dallas Regional Medical Center recently made a life-saving diagnosis for a North Texas man who entered the emergency department believing he was having a heart attack.

Dr. Prasad Maddukuri was the cardiologist on call when the patient came into the ER and performed the heart catheterization. When no blockage was found Dr. Maria Viqar-Syed was called in.

Viqar said the 53-year-old patient came to the hospital with chest pain and dizziness. He was taken to the CATH lab to make sure there were no blockages in his arteries, and doctors found none. He was then given an electrocardiogram test, and that’s when doctors knew instantly he has Brugada syndrome. It’s not the first case for Dallas Regional, but it is a rare disorder with an estimated 5 in 10,000 people being diagnosed.

According to the National Organization of Rare Disorders (NORD), “Brugada syndrome is a rare inherited cardiovascular disorder characterized by disturbances affecting the electrical system of the heart.

Viqar said this syndrome could lead to ventricular fibrillation, which is a life-threatening rhythm.

"It usually gets diagnosed in adulthood; he was sort of a bit late for his age in presentation. Then we found out the patient hasn’t had a medical checkup in the past and never sought medical advice until he started having chest pains,” she said. "His EKG showed classic Type 1 Brugada pattern." 

According to NORD, reports have suggested that Brugada could be responsible for up to 20 percent of sudden deaths in patients with structurally normal hearts. It can present itself as sudden unexpected nocturnal death syndrome (SUNDS), which is prevalent in Southeast Asia, and sudden infant death syndrome (SIDS).

"Not only did we correctly diagnose him, but also identified this disorder for him, did an EP (electrophysiology procedure) study, we gave him a defibrillator to prevent his risk of sudden cardiac death,” Vigar said.

Additionally, the doctors recommended his family get an EKG and genetic testing.

"I did not give him the option of following up with us as an outpatient because such patients would be less likely to follow up, and next time you would find them in the emergency department in full-blown cardiac arrest. We wanted to prevent that because he was a high-risk patient,” she said.

Vigar added that since it’s a rare disorder, many doctors who are not cardiologists are unlikely to diagnose it properly, and on the first look of the patient’s EKG they would mistake it for a lack of blood supply to the heart.

Thanks to the cardiologists and staff at Dallas Regional, their Brugada patient was in and out of the hospital in roughly four days from the time he was diagnosed to the time he checked out.

Dallas Regional is an accredited chest pain center, one of a handful in the Dallas metro area.

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