Brugada Syndrome Diagnostic Criteria (Shanghai Score)
Identifies Brugada syndrome pattern on ECG — a cause of sudden cardiac death in structurally normal hearts. Guides electrophysiology referral and ICD consideration.
Score interpretation
Shanghai score < 2 — Brugada syndrome not diagnosed; a type 1 ECG pattern (spontaneous, fever- or drug-induced) is required.
→ Consider sodium channel blocker provocation test (ajmaline/flecainide) if clinical suspicion remains; genetics referral; Holter monitoring
Shanghai score 2–3.
→ Electrophysiology referral; avoid sodium channel blockers, cocaine, cannabis; treat fever promptly; genetic testing; family screening; avoid competitive sport until risk-stratified
Shanghai score ≥ 3.5.
→ ICD implantation for symptomatic patients; quinidine for frequent VF episodes; avoid triggering drugs (list at brugadadrugs.org); high-risk family members need screening; genetic counselling
Interpretation bands for the Brugada Criteria. Apply clinical judgement and local guidance.
References
- Antzelevitch C, et al. J-Wave syndromes expert consensus conference report: emerging concepts and gaps in knowledge. J Arrhythm. 2016;32(5):315–339.
Related
Curated clinical cross-links plus same-class fallbacks.
- Lidocaine IV (Cardiac Arrhythmia) · Antiarrhythmic
- Protamine Sulphate (Heparin Reversal) · Heparin Reversal / Cardiac Surgery
- Mavacamten · Cardiac myosin inhibitor
- Prednisolone (Sudden Sensorineural Hearing Loss) · Corticosteroid (systemic — SSNHL treatment)
- Aciclovir 800mg Tablets (Ramsay Hunt Syndrome / Herpes Zoster Oticus) · Antiviral — nucleoside analogue (herpes zoster treatment)
- Digoxin · Cardiac Glycoside
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.