Cardiology: Brugada syndrome: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Cardiology: Brugada syndrome

Sample item

A 34-year-old man from Thailand collapsed at night and recovered spontaneously. His brother died suddenly in sleep at 30. ECG shows coved ST elevation with a right bundle branch block pattern in V1 and V2, and echocardiography is structurally normal. Which intervention best prevents sudden death in him?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Implantable cardioverter-defibrillator

Brugada syndrome is a sodium channelopathy (often SCN5A) causing polymorphic ventricular tachycardia or fibrillation, mainly in young men and often at rest or sleep. After a syncope or aborted arrest, an ICD is the only proven protective therapy. Fever should be treated promptly and sodium channel blockers and some other drugs are avoided.

Option by option

  • A. Permanent pacemaker implantation

    The problem is a ventricular tachyarrhythmia, not bradycardia, so pacing does not prevent it.

  • B. Beta-blocker therapy

    Beta-blockers are protective in long QT syndrome but are not effective in Brugada syndrome and may unmask the pattern.

  • C. Implantable cardioverter-defibrillator (correct)

    An ICD terminates ventricular fibrillation and is indicated in symptomatic Brugada patients.

  • D. Long-term oral amiodarone

    Amiodarone has not been shown to prevent sudden death in Brugada syndrome.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Implantable cardioverter-defibrillator. Brugada syndrome is a sodium channelopathy (often SCN5A) causing polymorphic ventricular tachycardia or fibrillation, mainly in young men and often at rest or sleep.

Why is "Permanent pacemaker implantation" not the answer?

The problem is a ventricular tachyarrhythmia, not bradycardia, so pacing does not prevent it.

Why is "Beta-blocker therapy" not the answer?

Beta-blockers are protective in long QT syndrome but are not effective in Brugada syndrome and may unmask the pattern.

Why is "Long-term oral amiodarone" not the answer?

Amiodarone has not been shown to prevent sudden death in Brugada syndrome.

What concept does this question test?

It tests Cardiology: Brugada syndrome in General Medicine. After a syncope or aborted arrest, an ICD is the only proven protective therapy. Fever should be treated promptly and sodium channel blockers and some other drugs are avoided.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: Brugada syndrome?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.