The Brugada Challenge
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| How the Concert Started |
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| How My Evening Ended |
I wanted to write something clever for this blog post, but I think the pictures do a good enough job getting your attention. Here’s how i ended up in the hospital.
I had collapsed in the middle of June at a Death Cab for Cutie concert. When the medics checked me out, they noticed an irregular heart rhythm suggesting that a heart attack was imminent.
An ambulance came and a second set of EMTs performed another EKG. Since it was at a concert venue, they thought maybe interference from the music or the instruments was skewing the measurements. It wasn’t. The second EKG confirmed the irregular heart rhythm so they treated me as if I was at risk for a cardiac event.
It was puzzling for them because I was an otherwise healthy middle aged man. How could I be at risk for a cardiac event?
My evening went from “Death Cab for Cutie” to “Really Expensive Cab to Hospital”
Upon arrival at the ER they perform a third EKG, which was no different than the first two EKGs.
They get in contact with a cardiologist and recommended I stay the night at the hospital, since they were concerned that I might have a heart attack that night.
Their initial theory is that I may have a genetic disorder called “Brugada Syndrome,” which is where the electrical signals to my heart can get mixed up and suddenly misfire. It’s more prevalent in middle aged Southeast Asian men and I 100% fit the bill.
Unfortunately, often the first noticeable symptom of Brugada is sudden and inexplicable death. Doctors often figure it out after the fact.
They transfer me to a regular bed, take my blood, then keep me on a heart monitor to make sure I didn’t die in my sleep.
The next morning the doctors order an echocardiogram to rule out any structural issues with my heart. The tech didn’t see anything out of the ordinary so they moved on to the next test.
They wanted to stress my heart and try to trigger the Brugada syndrome. They wanted to put a substance in my system that would stress out my nervous system and trigger heart palpitations.
They referred to it as “The Brugada Challenge,” to which I told them that something like that can potentially go viral on Tiktok. Like maybe i can do a dance and point to the air, with facts about Brugada, all synced to music of course.
Except I wasn’t really able to dance because I was a fall hazard since I was admitted for passing out in the first place. Plus I had an IV in each arm. And I had 12 electrical leads on my chest. And I was in the cardiac ICU. And my heart could have stopped at any time.
If they could successfully trigger a cardiac event, that would have confirmed the diagnosis of Brugada. In which case I would have been carted off to surgery to install an ICD, which is a defibrillator that would always be in my chest. Think Iron man but not quite as cool
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| Not sure if insurance would cover something like this |
ICDs are a little bit like Pacemakers, except they detect when my heart beat erratically and would essentially would FORCE CLOSE/RESTART my heart so I wouldn’t die of cardiac arrest.
The test itself was a little over two hours long. The substance is called procainamide and they were going to administer it into my blood stream via an IV drip over 40 minutes. Then they’d take an EKG of my heart every 10-20 minutes for the next 2 hours.
Despite the stress test, my heart rate never went above 72, and my EKG read identical every single time.
After the test, the electrophysiologist debriefed me on the results over the phone. The fact that he called on the phone was a relief since I figured anything serious would have been in person.
He had consulted with a few other of his peers and they concluded that although they couldn’t 100% rule out Brugada, they were sure that I wasn’t going to drop dead any time soon.
For outpatient care, i needed to follow up with my family doctor and then again with another cardiologist to see it we can rule out Brugada completely by looking for genetic markers.
What were the takeaways from the whole thing? a few.
- This wasn’t due to my running. I get that question way too many times and this has zero relation to the fact that I run. Brugada is a genetic disorder and a cardiac event could happen at any time. Statistically, marathon runners are 10 times more likely to die of a car accident on the way to the marathon course than they are of any sort of cardiac event while running the race.
- the doctors concluded that my passing out was probably related to me being outside on a warm afternoon. i hadn't hydrated and had a cocktail right before i fainted. so most likely it was a vasovagal syncope (just a common faint)
- personally im going to cut out all alcohol. i already have a low heart rate so taking a relaxant like alcohol makes me more susceptible to passing out. additionally im going to be more mindful of my water levels.
- If I’m feeling light headed, dizzy or nauseous, I’m going to sit down. Not going to explain it, even if it’s a middle of a presentation or a conversation, I will excuse myself and sit down until I’m not longer light headed.
- I really appreciate all the staff at the venue, the stranger who attended to me immediately after I fell, in the ambulance, and the hospital who treated me with nothing but kindness. I made the effort to remember everyone’s name but of course so many things happened so quickly i couldn’t get everyone. If i didn’t mention you, rest assured I’m still incredibly grateful!
- The stranger at the concert who was an off duty EMT who saw to me immediately after my fall
- The medical staff at the McMenamins Edgefield
- The EMTs who drove me to the hospital
- Dr Chen my cardiologist
- Nurse Taylor
- Nurse Abby
- Ian the EKG Tech
- Dr Meyers the electrophysiologist
- Thank you to Death Cab for putting on a great show, I hope? I never got to see them :( they were my wife’s favorite band and I hope they come back to Portland. I’ll have to catch you guys then! Also I hear rumors that some of you are avid runners. Hit me up and we can do trails!
- All the friends and well wishers to visited and sent their letters, kind words, thoughts and prayers.
- Lastly my wife for choosing me over the opportunity to see her favorite band up close in personal. She did not hesitate for a second what she wanted to do. Was by my side every step of the way. Advocated for me to the doctors and made sure everyone was on the same page as far as procedures and whatnot were concerned. I love you, Hannah. For always taking care of me. Being so mindful was what made my heart skip a beat and to fall for you in the first place. (And taking care of business when my heart literally skipped a beat and I literally fell).
