A case of sudden unexplained nocturnal death from overlooked Brugada syndrome at a pre-employment check-up.

According to the International Classification of Disease (ICD-9), sudden death (SD) is defined as natural and unexpected death, heralded by an abrupt loss of consciousness within 24 h of the onset of acute symptoms. A specific variation of SD has been observed in Southeast Asians. Baron et al. reported 51cases of sudden unexplained nocturnal death (SUND) among Southeast Asian refugees to the Centers for Disease Control as of April 1983. In 1992, Brugada and Brugada reported eight patients who manifested a right bundle branch block (RBBB), with ST segment elevation in leads V 1 to V 3 , and with a high incidence of ventricular fibrillation (VF). This combination has been labelled the Brugada syndrome and is often complicated with syncope or SD. We have retrospectively studied the electrocardiograms (ECGs) of 8,181 workers examined at the Health Examination Center of Gamagori Medical Association during the period of March 1995 to August 2001, in order to calculate the incidence of the Brugada syndrome among the workers. And a 25-yr-old man who died of SUND at night, revealed the Brugada syndrome (Fig. 1). The present study is the case report.