Bundgaard Syndrome as a Rare Cause of Diffuse ST-Segment Depression: The First Reported Case in Turkey

Background: Familial ST-segment depression syndrome (Bundgaard syndrome) is a recently defined, dominant inherited heart disease characterized by widespread nonischemic ST-segment depression and an increased risk of atrial and ventricular arrhythmias, heart failure, and sudden cardiac death (SCD). Case Summary: A 41-year-old male patient presented with chest pain and generalized ST-segment depression (with aVR elevation) and showed slowing of left anterior descending artery flow on angiography. Normal scintigraphy, family history of SCD, and stress test findings supported the diagnosis of Bundgaard syndrome. The patient was treated conservatively without implantable cardioverter-defibrillator implantation, and regular follow-up was planned. Discussion: Establishment of the diagnosis and family screening is crucial to offer early treatments of arrhythmias and heart failure to improve outcomes and prevent SCD. Take-Home Message: Bundgaard syndrome, which can be a precursor to malignant arrhythmias, should be kept in mind in patients with persistent widespread ST-segment depression without ischemia.