Over one-third of patients with Brugada syndrome (BS) experience sudden cardiac arrest (SCA), which may be the first or second clinical finding. Unlike SCA in other arrhythmias, in patients with BS, SCA usually is not induced by exercise but rather by high fever (in children) and in adults, high alcohol consumption and night sleep.
Occasionally, SCA may be seen in patients who eat a large bite of food, in which the SCA seems to be the result of vagal stimulus.
A Turkish team of investigators reported a case of SCA in a 9-year-old child who was eating a large hot dog. The patient was successfully defibrillated and resuscitated and then underwent an electrocardiographic evaluation, which found a suspicious ST elevation in V2. There was no family history of arrhythmia, and the patient’s ECG, exercise stress test, and other biochemical analyses were normal.
The patient was diagnosed with BS after the ajmaline test revealed a type 1 Brugada pattern, and an implantable cardioverter defibrillator was implanted.
The researchers concluded that vagal stimulus–dependent SCA after eating a large bite of food may be the first symptom of BS. “For this reason, the electrocardiographic results of the children who had a cardiac arrest after eating a large meal with big bites should be evaluated in detail.”
Ozyilmaz I, Akyol B, Ergul Y. Sudden Cardiac Arrest While Eating a Hot Dog: A Rare Presentation of Brugada Syndrome in a Child. Pediatrics. 2017 Sep 6. [Epub ahead of print]