Brugada syndrome: symptoms, causes, diagnosis, treatment and living with it

The heart rhythm is controlled by electrical messages. The BHF explains that in Brugada syndrome the messages do not get delivered to the heart's cells properly because the heart's channels (tiny pores) are not working as they should, which causes an abnormal heart rhythm.

The NHS says Brugada syndrome can also cause a dangerously fast or irregular heartbeat. This can lead to a cardiac arrest, where the heart beats so fast that not enough blood gets to the brain, so you become unconscious and stop breathing. The BHF stresses it is a serious but rare condition and that most people with the condition manage their risk with simple lifestyle choices.

The NHS says Brugada syndrome does not usually cause any symptoms and is sometimes found when you have an electrocardiogram (ECG) for another reason. The BHF says many people have no symptoms.

• Fainting or blackouts.

• Feeling dizzy or lightheaded.

• Heart palpitations (a fluttering or pounding in the chest or neck).

• Seizures or fits.

• Shortness of breath.

The BHF says that although symptoms can occur at any time, some triggers can be dehydration, drinking lots of alcohol and having a fever or high temperature. The NHS says it is important to avoid triggers that can cause problems with your heart rhythm, and that your care team will give you advice.

The BHF says Brugada syndrome is usually diagnosed with an ECG, which records the electrical activity of the heart through sensors stuck on the chest, arms and legs. If your ECG appears normal but you have symptoms, you might need other tests, such as another type of ECG after an injection of medicine that tries to make the heart go into an abnormal rhythm in a controlled way (a provocation test), or wearing a portable ECG for 24 or 48 hours (a Holter test).

The NHS says if a GP thinks you could have Brugada syndrome they will refer you to a cardiologist, and as it is usually inherited you may be offered genetic testing. If you are diagnosed, your immediate family should also be offered testing.

The BHF says there is currently no cure for Brugada syndrome. The NHS says that if you have it but have not had any symptoms you will not usually need any medical treatment, as most people have a low risk of serious problems, and you will be monitored regularly to check the health of your heart.

Doctors may recommend an implantable cardioverter defibrillator (ICD), a small device put under the skin of the chest, similar to a pacemaker, which monitors the heart rhythm and sends an electrical shock when needed to correct it. The NHS says you will only need one if you have had symptoms such as cardiac arrest, palpitations or fainting, or doctors think you are at high risk of a dangerous heart rhythm based on your ECG results. The BHF adds that medicines such as beta blockers may help in some cases.

The NHS says Brugada syndrome is usually caused by genes you inherit from your parents. Less commonly it can be caused by problems with the structure of the heart, taking certain medicines or using drugs such as cocaine. It is more common in men and in people of south east Asian origin.

The BHF says the gene that can cause the condition can be passed from parents to their children, so most people with Brugada syndrome can plan to have children but should speak to their GP or specialist team first and may be referred for genetic counselling.

The BHF says many people with Brugada syndrome can live normal lives and do everyday activities such as driving, exercising and having children, although some people have symptoms that affect daily activities. If you need an ICD there may be things to plan for, such as not driving for a little while after it is fitted. Always tell medical staff you have Brugada syndrome, and discuss over-the-counter medicines and supplements with your doctor.

Your care team will pass information to the National Congenital Anomaly and Rare Disease Registration Service, and you can opt out at any time. The NHS names the British Heart Foundation and Cardiac Risk in the Young as sources of support.

The NHS says to call 999 if someone is not breathing normally and not moving or responding (they could be having a cardiac arrest), if someone is having a seizure or fit, or if someone has fainted or had a blackout and cannot be woken up within 1 minute. Follow the instructions from the 999 operator until an ambulance arrives.

Ask for an urgent GP appointment or get help from NHS 111 if you have been diagnosed with Brugada syndrome or are worried you have it and you have fainted or had a blackout and have now recovered, have dizziness that does not go away or keeps coming back, have palpitations that keep coming back, last longer than a few minutes or are getting worse, or have had a seizure and recovered. Also ask for an urgent GP appointment if your parent, child, brother or sister has been diagnosed with Brugada syndrome or died unexpectedly.

On the NHS, Brugada syndrome is assessed by a cardiologist, often in an inherited cardiac conditions service, with ECG and genetic testing and family screening. ICDs are implanted by specialist cardiac teams. Private cardiology and genetics consultations are available, but family testing and device follow-up are best kept with a specialist inherited cardiac conditions team and your GP kept informed.