[ender18d]

So most of the MDs have PMd me and identified the rhythm, and I think no one else is going to wade in, so the answer:

This patient had Brugada Syndrome, a channelopathy that can predispose patients to arrhythmia and sudden cardiac death. Its an autosomal dominant genetic disorder, and this is likely what claimed her father's life. The EKG findings of Brugada are not always present (you can have a normal prior EKG) and Brugada "attacks" can be precipitated by alcohol use. This patient's EKG normalized when she sobered up.

She was admitted to Cardiology for an AICD placement.

Brugada has different forms, but should be considered in a syncopal patient with EKG findings of ST elevation in V1-3, especially if combined with T wave inversion as seen in this EKG.

If y'all want to keep going I have some other good real patient syncope scenarios for you.