• L Douglas Smith, Sarah Gast, and Danielle F Guy.
• L. Douglas Smith Jr is an acute care nurse practitioner at TriStar Centennial Medical Center, Nashville, Tennessee, and an instructor of nursing at Vanderbilt University, Nashville.
• Crit Care Nurse. 2021 Oct 1; 41 (5): 15-22.

BackgroundBrugada syndrome is a genetic disorder of cardiac conduction that predisposes patients to spontaneous ventricular arrhythmia and sudden cardiac death. Although Brugada syndrome is one of the most common causes of sudden cardiac death, patients presenting with the syndrome often go misdiagnosed. This error has potentially fatal consequences for patients, who are at risk for sudden cardiac death without appropriate management.ObjectiveTo increase the critical care professional's knowledge of Brugada syndrome through detailed description of the characteristic electrocardiographic findings, an algorithmic approach to electrocardiogram evaluation, and a case report of a patient with a previously missed diagnosis of Brugada syndrome. The essential concepts of epidemiology, pathophysiology, clinical presentation, risk stratification, and management are reviewed for critical care professionals who may encounter patients with the syndrome.DiagnosisPatients typically present with syncope or cardiac arrest and an abnormal electrocardiographic finding of ST-segment elevation in the precordial leads. The diagnosis of Brugada syndrome centers on identification of its electrocardiographic characteristics by critical care professionals who routinely evaluate electrocardiograms. Critical care professionals, especially nurses and advanced practice nurses, should be proficient in recognizing the electrocardiographic appearance of Brugada syndrome and initiating appropriate management.InterventionsManagement strategies include prevention of sudden cardiac death through lifestyle modification and placement of an implantable cardioverter-defibrillator. Critical care professionals should be aware of commonly used medications that may exacerbate ventricular arrhythmia and place patients at risk for sudden cardiac death.ConclusionIncreased awareness of Brugada syndrome among critical care professionals can decrease patient morbidity and mortality.©2021 American Association of Critical-Care Nurses.

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