Monday, March 14, 2011

Medical Mondays: A Death in the Night, part 1

Hey all!

I've been having a back-and-forth conversation with the amazing and sweet Len Lambert--check out her blog Conversations with Self if you have a moment.

She has a character that sadly, must die in during her sleep. A young person, maybe in her thirties.

What could cause something like this?

First, we have to consider the character. She is very young, so the chance that she might have sudden cardiac death (SCD) due to atherosclerotic heart disease would be less likely (this is the #1 cause of sudden death in the world--95% of the time)

What else could cause SCD at her age? I came up with a few possibilities, but each is really interesting, so today I'm going to tackle Brugada Syndrome.

This is a rare condition that affects less than 0.4% of the U.S. population, but as high as 1% in some Asian populations. Some may have unexplained episodes of fainting (syncope), but most have no symptoms at all. People have a peculiar abnormality seen on an EKG, or ECG, but most people don't have them done routinely, so it would be easily missed. Men have it far more often than in women.

People with Brugada syndome often suffer SCD during sleep via a fatal arrhythmia, usually ventricular fibrillation. It's the #1 cause of SCD in Southeast Asian men, where it's called Sudden Unexpected Nocturnal Death Syndome, or SUNDS. Men often die in their sleep after a carb-heavy meal, which makes their condition more susceptible to arrhythmia.

SCD in Brugada Syndrome can also be provoked by other factors: local anesthesia, tricyclic antidepressants, lithium, fevers, low potassium levels (this is linked to a high carbohydrate meals, see above in SUNDS), hi potassium or calcium levels, and cocaine use.

I'm sure I've seen Brugada syndrome mentioned in some crime shows or movies but I can't remember which ones.

Have you ever heard of Brugada Syndrome?

Please keep in mind this post is for writing purposes only and is not to be construed as medical advice, or homicidal advice, yeesh.

If you've got a fictional medical question, let me know! Post below or email me at
All I ask is that you become a follower and post a link on your blog when I post your answer.

59 comments:

Melissa said...

I've never heard of Brugada syndrome - but then, I don't know much about this medical stuff. That's why your blog is invaluable! I get to learn things every week.

Laura Pauling said...

No, I've never heard of this - but it's scary. What a great resource this blog is!

Jessica Bell said...

That's really interesting. No, I haven't ever heard of it. But wow. I might write this one down! Thanks!

salarsenッ said...

No, never heard of it before. Sounds scary and unexpected. I wonder how many have died from it before it was a classified syndrome? (Just my curious brain at work...)

Stina Lindenblatt said...

I haven't heard of it either even though I do have a background (slight) in cardiology. Scary stuff. Now I'm going to make sure my husband doesn't have a carbo rich meal right before bed, just in case.

Terri Tiffany said...

I have never heard of this. Last Thurs night, a good friend of ours died during her sleep--age 54, healthy. They are doing an autospy to discover why someone like her would die like this. We had been wondering why too and your explanation is interesting and I await the results.

Matthew MacNish said...

I've never heard of this, but I love that there is almost always a legitimate medical explanation for anything plot related you need to do in your story, even if it's rare.

Giles Hash said...

I know I haven't heard of Brugada Syndrome, but anything that could cause sudden death in the night is pretty disturbing. It's good to know there are ways to kill off a character, though, without them having to get murdered :)

Claire Gregory said...

Hi Lydia- I hadn't specifically heard of this syndrome, but I did come across Sudden Arrhythmia Death Syndromes recently while researching medical foundations, and I see Brugada is one of those. I first heard of SADS when Irish footballer Cormac McAnallen died suddenly in his sleep a few years ago- he had only recently toured Australia with the national team, and many of us down here had admired his great sportsmanship, and were so surprised and sad when he passed.

B.E. Sanderson said...

Nope, never heard of it. But now my hypochondriac self will worry about it at night - after high carb meals. ;o)

Seriously, though, thanks for the info. Another great medical post.

Connie said...

I'd never heard of Brugada Syndrome before. I love discovering all the rare and strange diseases/disorders you post about.

welcome to my world of poetry said...

Some times ignorance is bliss.
There are some conditions I rather not know about, I think you are doing a grand job and as you say it's not for medical purposes but if a person tend to worry about health problems(I don't) then perhaps they shouldn't read.

Yvonne,

Carol Kilgore said...

Totally new to me. Since I write mystery, this is something I might put to good use one day. Thanks.

Angela Felsted said...

I haven't heard of Brugada Syndrome, but I have heard of Long QT Syndrome, which sounds similar.

My husband's brother died from sudden heart failure at 18. No one knows why.

Jess said...

I've never heard of this, but it sounds scary! Plus, I go to sleep after eating a lot of carbs sometimes...dang it, no more late night snackies :)

Karen Lange said...

I haven't heard of this. It seems you educate me every Monday. :) Have a great week!

Chris Phillips said...

I haven't heard of this, but I fainted once when I was 14, so I probably have it. That or Lupus.

Hannah Kincade said...

Yes, my cousin died of sudden heart failure when he was 18. They found out what it was, I can't remember the name, but it was hereditary. We all had to be tested afterwards. I was in junior high so that was what? about 20 years ago.

Munk said...

Thanks Lydia, very interesting stuff. The human body is a complicated device.

Erica Mitchell-Spickard said...

Never heard of it, but you just fed the hypochodriac in me! ;) You always dig just a little deeper in the Med advice (to which I have little knowledge above reading a thermometer) and bring interesting things to the creative table. <3 awesome!

vbtremper said...

I watch so many of those CSI/crime shows, but I don't remember hearing about Brugada syndrome. Yikes, kinda scary.

Your knowledge is fearsome (in a really good sort of way)!
-Vicki

Shellie said...

I should really be keeping a list of the many ways there are to kill off a character. Thanks!

The Red Angel said...

Brugada Syndrome sounds so awful! :( What a sad way to be "ended", to just die during sleep. On the other hand, I guess it is a peaceful way to die because you don't know that the next time you wake up you...well, won't.

~TRA

http://xtheredangelx.blogspot.com

Bossy Betty said...

This would be so sad in real life, but it's such a handy tool for an author!

Magan said...

These medical Mondays are always so interesting! I wish I had something that I was good at to share...okay so people ask me a lot of insurance questions, but that's not interesting.

Olivia Green said...

I recently found your blog and it's been extremely helpful, so I gave you an award over at mine. Thank you for these great posts, please keep them coming. :)

KatieO said...

Thanks for another great and obscure tool for the writer's toolbox!

Old Kitty said...

Yay!! I love Len and her wonderful blog!!! Yay!!

Thanks for such an interesting post about an illness I've not heard of before!!! Thoroughly fascinating and a little scary! Thank you! take care
x

Olga said...

I have never heard of Brugada Syndrome. It seems to be very rare, and it sounds frightening.

Linda Gray said...

Fascinating! Never heard of it, but the details are interesting, and frightening. I've sent you an email with a medical question from my ms., Lydia. Thank you.

Erin Cole said...

Hi Lydia,

I have never heard of Brugada Syndrome, but I'm locking that one away in the synaptic bank for possible use in a future story.

I am so glad that you are open to answer medical questions for fiction, because I've been grappling with how a character of mine will die. Here is my question:

Unfortunately, my character must die a gruesome death, but by natural causes. Frankly, it needs to be bloody, so that it looks like a murder. I thought that maybe she could die of electrocution in the bathtub, and then because she was taking large doses of probiotics, her body (excuse the gore here) rather explodes (due to the yeast in the probiotics and the heat of the bath). Is this medically possible?
Thanks for your time!

Heather said...

I haven't heard of this, how interesting! This gives an option of something unique in a story as opposed to the obvious. Love it!

Jonene Ficklin said...

Great post as usual, Lydia. Thanks for sharing!

Steph said...

Awesome! I may hit you up if and when I get to continuing my novel! I do have an ailing protaganist!

LTM said...

holy mackrel, that was a lot of very scientific-sounding words! :D But it is very interesting. Thanks for the info... now to kill a character! j/k~ <3

The Golden Eagle said...

I've never heard of it before--fascinating post!

mist of the blossom rain said...

I have never heard of it. It's very sad though.

M Pax said...

I have not heard of this syndrome. Your medical mondays are so interesting.

Abby Minard said...

I"ve never heard of it either. But I don't know much, and I try not to google stuff because it leads to me being all paranoid I have something ;p I'm sure I'll connect myself to all the symptoms of half the stuff you talk about ;p

Jennifer Hillier said...

Wow, fascinating stuff! I've never heard of Brugada Syndrome but it definitely sparks all kinds of interesting story ideas...

Michelle Teacress said...

I've heard of lethal arrhythmias before, but I didn't know there was one so gender/race specific.

I have an arrhythmia, but have been told it's pretty normal/non life threatening. Thank heaven.

Interesting post, as usual! Thanks. :)

lbdiamond said...

A great post as always!!!

Alleged Author said...

Great! One more thing for me to freak out about. Thanks for the info!

Jennie Bailey said...

I have never heard of brugada syndrome. I love your Medical Mondays, but the hypochondriac in me always hopes for something that I have no way of contracting/being born with. ;-)

Colene Murphy said...

Oooh! Interesting stuff!!

Jemi Fraser said...

I always learn so much from you! love it :)

Liza said...

As always, a fascinating Monday post.

Lynn said...

No, I have never heard of this and I wonder, working the dental field like I do, if dentists are aware considering local aneasthetic could be a trigger. Interesting!!

Meredith said...

I always wondered how people died in their sleep, especially if they didn't have health concerns before. How terrifying!

Lenny Lee* said...

hi miss lydia! for sure i didnt ever hear of that. wow you got me learning sooo much. i like all this medical monday stuff.
...hugs from lenny

Rachna Chhabria said...

Though I did not know that it was called Brugada Syndrome, I had heard of people dying in their sleep. I assumed it was a cardiac arrest. Interesting post, Lydia.

Roland D. Yeomans said...

Amazing. I had never heard of this syndrome. It would be chilling to go to bed with your young wife, only to awaken to her dead. Chilling. And it could happen. Brrrr.

Heather Hellmann said...

Wow, I learned something new today!

Ciara said...

I've never heard of this. I learned something new. I think it's important if you going to kill of the character to make sure it's plausible. Good job.

Saumya said...

We just learned about this a couple of weeks ago! Lydia, you do such an incredible job of weaving medicine with characters...and helping others with the details of their characters! I love your medical mondays :)

Len Lambert said...

I've learned of it only when you told me about it. Thank you ever so much, Lydia, for this very informative post. You are ever so helpful! This is very helpful for my current WIP. Really appreciate the time and effort you've put into writing this post.

Medeia Sharif said...

I haven't heard of this syndrome.

I sometimes have to look up medical facts for my writing. Maybe I'll shoot a question your way in the future. :)

Ginny said...

I discovered your site while doing one of my periodic web searches to see if anyone has mentioned brugada syndrome in their postings. Exciting to think about the syndrome as part of a novel! I write www.brugadasyndrome.blogspot.com and invite you to check it out. I try to add things that are of interest to anyone with the syndrome, or interested in it for any reason. Enjoyed your blog!

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