ABSTRACT
BACKGROUND: Pharmacologic challenge test is often used to diagnose Brugada syndrome (BrS) when spontaneous electrocardiograms (ECG) do not show type I Brugada pattern but reported sensitivity varies. The role of the exercise stress test in diagnosing Brugada syndrome is not well-established. CASE SUMMARY: A patient had a type I Brugada pattern ECG during the recovery phase of exercise stress test but had a negative procainamide challenge test. He had a loop recorder implanted and later survived a ventricular fibrillation (VF) arrest provoked by coronavirus disease 2019 (COVID-19). Electrocardiogram on arrival showed type 1 Brugada pattern. He was discharged after implantable cardioverter-defibrillator implantation. He later underwent genetic testing and was found to be heterozygous for c.844C>G (p.Arg282Gly) mutation in the SCN5A gene. DISCUSSION: Type 1 Brugada pattern ECG may be unmasked by ST-segment augmentation during recovery from exercise. Exercise stress test may play a role in the diagnosis of Brugada syndrome when suspicion for Brugada syndrome remains after a negative procainamide challenge test or if the patient has exercise-related symptoms. COVID-19 can unmask BrS and trigger a VF cardiac arrest.
ABSTRACT
The Chinese Communist Party (CCP) has received plaudits from international press and organizations for their handling of the COVID-19 crisis, with some describing it as a win for China in terms of propaganda. In this essay, I explore an alternative view: That the CCP is responsible for the origin and extent of the pandemic, and that much of their perceived altruism is carefully disguised opportunism and propaganda. Facts are drawn from scholarly work and the popular press to support my arguments. This essay carries strong implications for interpretation of recent events.
ABSTRACT
From late 2019 to the first half of 2020, the world has witnessed the epic spread and destruction of the novel coronavirus which was discovered in Wuhan, China. The huge number of infections and deaths caused by the virus, the collapse of the healthcare system and the economic consequences have few modern equivalents. While governments of all countries are responding to the pandemic, a heated debate rages about which political system, democracy versus authoritarian, is better positioned to respond to the pandemic. While the worldwide effort to contain the virus continues, we offer a preliminary comparison between democracies and authoritarian regimes in their responses to COVID-19, and policy suggestions for democracies to improve their governance and their ability to respond to crises.