American Board of Internal Medicine (ABIM) Certification Practice Exam

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What type of ST-segment elevation is associated with Brugada syndrome?

  1. Convex ST-segment elevation

  2. Horizontal ST-segment elevation

  3. Coved ST-segment elevation

  4. Flat ST-segment elevation

The correct answer is: Coved ST-segment elevation

Brugada syndrome is characterized by a specific pattern of ST-segment elevation, which is most notably the coved type of ST-segment elevation. In this condition, the ST segment rises abruptly from the baseline and then descends gradually, creating a distinctive shape that resembles a "cove." This pattern is typically observed in the right precordial leads (V1-V3) on an electrocardiogram (ECG). The coved ST-segment elevation is a hallmark of Brugada syndrome and serves as a vital diagnostic criterion. This pattern can lead to increased risk of life-threatening ventricular arrhythmias and sudden cardiac death, especially in individuals who are young and otherwise healthy. The presence of this specific type of ST-segment elevation can aid in distinguishing Brugada syndrome from other conditions that may also present with ST elevations, ensuring appropriate management and risk stratification for those affected.

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