Early repolarization

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Background

  • Mostly seen in healthy patients <50, less likely >50, unlikely >70
  • Typical patient is male, black, athlete
  • Shows diffuse ST elevation similar to pericarditis and STEMI
  • Underlying pathophysiology poorly understood, however, it is a normally a benign process

ECG Findings

  • Widespread concave ST elevation more prominent in V2-V5, elevation of ≥0.1 mV in two adjacent leads
  • Notching or slurring of the J point
  • ST elevation is <25% of the T wave height in V6
  • No reciprocal ECG changes or ST depressions (unless in aVR or V1)
  • ST changes stable over time

Early Repolarization Syndrome

  • Early Repolarization is a benign finding with asymptomatic patients
  • Early Repolarization syndrome applies to patients with early repolarization along with symptomatic arrhythmias such as Ventricular Fibrillation
    • This is a diagnosis of exclusion

Differential Diagnosis

  • STEMI
  • Pericarditis

See Also

References