Chest pain and ST elevationBMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e4323 (Published 27 June 2012) Cite this as: BMJ 2012;344:e4323
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In their report of a 57 year old Vietnamese man, with an electrocardiogram indicating a Brugada phenotype, Page et al appear to have omitted an important message concerning sudden unexpected death (SUD) in males from South East Asia.1
Recognised in many of these countries, including Thailand (‘Lai-Tai’ syndrome), Laos, Vietnam and Kampuchea, in addition to countries on the pacific rim, including the Philipines (‘Bangungot’ syndrome), Korea, Japan (‘Pokkuri’ disease) and Singapore, several reports have described this phenomena of SUD. Described in the indigenous populations and in migrants from these countries, it is almost exclusive to young men of age 20-49 years, with most dying suddenly and unexpectedly in their sleep.
In many cases, survivors have been shown to have a Brugada-type electrocardiogram. The greatest prevalence appears in north-eastern Thailand and amongst members of the Hmong tribe which extend into Laos, China and Vietnam.3
Doctors sitting post-graduate exams should be aware of this geographical association of sudden death in young males, in and from, South East Asia.
1. Page SP, Archbold A, Abrams DJ. Chest pain and ST elevation. BMJ 2012;344:e4323 (14 July).
2. Parish RG, Tucker M, Ing R, Encarnacion C, Eberhardt M. Sudden unexplained death syndrome in southeast Asian refugees: a review of CDC surveillance. MMWR. 1987;36(1 SS):43SS-53SS.
Tatsanavivat P, Chirawatkul A, Klungboonkrong V, Munger R, Chaisiri S, Charerntanyarak L, Saowakontha S. Sudden and unexplained deaths in sleep (Lai Tai) of young men in rural northeastern Thailand. Int J Epidemiol 1992;21:904-910.
Competing interests: No competing interests