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It was easy to blame fatigue the first time he collapsed. He felt dizzy, his vision shifted, and then everything went black.

Within a minute, he was back on his feet, with no confusion. But the episodes kept coming, again and again, through 2024 and into 2025.

For a 25-year-old hockey player with no known medical history, it made little sense. Nothing in his symptoms pointed to a serious condition.

“His first episode of syncope (fainting) was in late 2024, around October. He noted a prodromal episode of dizziness, fatigue and visual changes before passing out. He came to after about 30 seconds to one minute with no significant changes in his sensorium,” said Dr Nelson Onyango, an internal medicine specialist who examined the unnamed patient.

Concern grew after he fainted while playing field hockey, prompting his referral to Aga Khan University Hospital in Nairobi.

It was there that Dr Onyango and his colleagues made a definitive diagnosis last year — one he believes could be the first documented case of Brugada syndrome in Kenya, a condition known to cause sudden death in young, otherwise healthy people, often during sleep.

“This diagnosis could be the index case of Brugada syndrome (BrS) in the country, a diagnosis that is well described in Asia and the West, but rarely in Sub-Saharan Africa,” he said.

The case underscores why fainting should never be dismissed without thorough investigation.

Brugada syndrome is difficult to detect. In this case, routine examinations revealed little cause for alarm. The player’s heart sounds were normal, his lungs were clear, and blood tests showed no major abnormalities.

His family history offered no clues. His mother had died after a prolonged illness when he was younger, but the cause was unknown to him.

The player, who works as a consultant in Nairobi, reported no stress related to his social life, work, family or relationships. He did not smoke cigarettes, aside from occasionally using flavoured hookah, and had no significant alcohol intake.

“His exam revealed a well-developed and well-nourished male in no acute distress,” Dr Onyango wrote in a case report published in the Cardiovascular Journal of Africa.

Yet beneath the surface, the electrical system controlling his heartbeat told a different story.

Although his heart maintained a regular rhythm, it was slightly slower than average, at 55 beats per minute. More tellingly, the electrical signals were taking longer than normal to travel between different parts of the heart.

The case report, titled “An Unexpected Diagnosis: Brugada Syndrome in a healthy Kenyan male athlete,” highlighted a critical finding: an unusual raised and curved pattern in the electrical activity on the right side of the heart — a hallmark of type I Brugada syndrome.

To confirm the diagnosis, doctors monitored his heart for more than 12 hours. The results showed a persistent slow heart rate and abnormal rhythms originating from the lower chambers, reinforcing the diagnosis.

“Brugada syndrome (BrS) is a known leading cause of sudden cardiac death in young patients with structurally normal hearts,” Dr Onyango said.

Most deaths, doctors note, occur at night, when the heart’s electrical system is more prone to triggering dangerous rhythms during rest or sleep.

The condition is rarely reported across much of sub-Saharan Africa, often due to misdiagnosis or missed diagnosis, making this Kenyan case particularly significant.

Dr Onyango emphasised that fainting in young people should never be ignored, even when everything else appears normal.

To manage the condition, the patient has been fitted with an implantable cardioverter defibrillator (ICD) — a small device placed in the chest that monitors the heart and delivers a shock if it detects a life-threatening rhythm.

He has been advised to avoid dehydration and alcohol, to treat fevers promptly and to manage physical exertion carefully. His family has also been trained in basic cardiopulmonary resuscitation (CPR). For now, he is not taking part in active sports.

Still, he has not given up on hockey.

“While this was a devastating diagnosis to take, it was a relief that there was an organic cause to the fainting episodes that I had experienced for several months,” he said.

“It was also a relief that there was a known cause and treatment and that over time, after observation and testing, I should be able to get back to playing field hockey.”