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Case Reports in Psychiatry
Volume 2014, Article ID 478397, 4 pages
http://dx.doi.org/10.1155/2014/478397
Case Report

Treatment of Anxiety and Depression in a Patient with Brugada Syndrome

1Behavioral Health Services, Cheyenne Regional Medical Center, Cheyenne, WY 82001, USA
2Department of Psychiatry, Geisel School of Medicine at Dartmouth College and Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA
3Department of Cardiology and Electrophysiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA

Received 30 May 2014; Accepted 26 June 2014; Published 10 July 2014

Academic Editor: Jaspreet S. Brar

Copyright © 2014 Jasper J. Chen and Rajbir S. Sangha. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Brugada syndrome is rare and has been a clinically diagnosable entity since 1992. Its clinical manifestations are highly variable, and while some patients remain asymptomatic, others endure sudden cardiac death. Initial presenting symptoms may include palpitations, seizures, syncope, and nocturnal agonal respiration. The diagnosis of Brugada syndrome relies on both clinical findings and characteristic ECG patterns that occur spontaneously or are induced by usage of sodium-channel blocking agents. Aims of Case Report. Many psychiatrists may be unaware of the possibility of medical cocontributing etiologies to physical symptoms of anxiety and depression. We present a case of a patient who was treated psychiatrically for anxiety and panic attacks and who was subsequently diagnosed with Brugada syndrome and treated medically with an implantable cardioverter defibrillator (ICD), the only treatment option demonstrated to be effective. Her psychiatric symptoms predated her diagnosis of Brugada syndrome by at least fifteen years. Conclusion. The patient's eventual diagnosis of Brugada syndrome altered the course of her psychopharmacologic medication management and illustrates the utility of a psychosomatic approach to psychiatric symptom management.