An Autopsy Case of Brugada Syndrome with Prominent J Wave in the Inferior Leads Presenting Headache and Chest Pain

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  • Ohtani Ryuji
    Division of Cardiovascular Medicine, Tokushima Red Cross Hospital
  • Yamashita Michiko
    Division of Diagnostic Pathology, Tokushima Red Cross Hospital
  • Chen Hirotoshi
    Division of Cardiovascular Medicine, Tokushima Red Cross Hospital
  • Tobetto Yohei
    Division of Cardiovascular Medicine, Tokushima Red Cross Hospital
  • Yoneda Kohei
    Division of Cardiovascular Medicine, Tokushima Red Cross Hospital
  • Izumi Tomoko
    Division of Cardiovascular Medicine, Tokushima Red Cross Hospital
  • Miyajima Hitoshi
    Division of Cardiovascular Medicine, Tokushima Red Cross Hospital
  • Yasuoka Tatsuo
    Division of Cardiovascular Medicine, Tokushima Red Cross Hospital
  • Ogura Riyo
    Division of Cardiovascular Medicine, Tokushima Red Cross Hospital
  • Yuba Kenichiro
    Division of Cardiovascular Medicine, Tokushima Red Cross Hospital
  • Takahashi Takefumi
    Division of Cardiovascular Medicine, Tokushima Red Cross Hospital
  • Hosokawa Shinobu
    Division of Cardiovascular Medicine, Tokushima Red Cross Hospital
  • Kishi Koichi
    Division of Cardiovascular Medicine, Tokushima Red Cross Hospital
  • Hiasa Yoshikazu
    Division of Cardiovascular Medicine, Tokushima Red Cross Hospital
  • Fujii Yoshiyuki
    Division of Diagnostic Pathology, Tokushima Red Cross Hospital

Bibliographic Information

Other Title
  • 頭痛と胸痛で発症し，下壁誘導に明瞭なJ波を伴ったBrugada症候群の1剖検例

Abstract

We report the case of a 27-year-old male who had visited our hospital complaining of headache and chest pain during sleep. He had neither a family history of sudden cardiac death nor a past history of syncope and arrhythmias. Twelve-lead ECG showed coved-type ST-segment elevation in the right precordial leads and prominent J wave in the inferior leads. Laboratory tests and echocardiography were normal. He made an emergency visit one month later, presenting cardiac standstill. He died without response to cardiopulmonary resuscitation. Autopsy revealed no gross abnormality. A more detailed pathological evaluation led to some characteristic findings. Bilateral ventricular wall showed irregular thickness with mild myocardial hypertrophy. An epicardial fibrofatty degeneration and myocardial bundle around the vasculature were observed in the left anterior and posterior wall, right wall of the apex, and right ventricular outflow tract. In addition, focal inflammation with multinuclear leukocytes was seen in the epicardium by the right ventricular outflow tract. These findings are consistent with previous autopsy reports for patients with Brugada syndrome.

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