Case 10, you're asked to see a nine-year-old boy whose father died suddenly at age 32. The father had a type one Brugada EKG patent prior to his cardiac arrest and was heterozygous for a pathogenic mutation in SCN5A on post-mortem testing. His son also carries that mutation and has the following EKGs. And it has been followed by serial EKGs. The son now presents to the emergency room with a cough and a fever of 101. On the left is his baseline electrocardiogram and on the right is his electrocardiogram in the presence of 101 fever. Which of the following best describes the finding and management of this nine-year-old? A, neither ECG is diagnostic of Brugada syndrome he can be sent home as he is not at significant risk of sudden cardiac death. B, he has Brugada syndrome and his EKG findings were exacerbated by the tachycardia. He should be admitted to the hospital and treated with beta blockers. C, he has Brugada syndrome and his ECG findings were exacerbated by the fever. He should be treated with Tylenol and admitted. D, he has Brugada syndrome and his ECG findings were exacerbated by the fever. He should be treated with quinidine and sent home if his ECG normalizes.

Brugada syndrome

SCN5A mutation

ECG findings

fever exacerbation

pediatric cardiology