EarlyRepolarization - ECG

Early repolarization is a relatively common incidental finding in the ECG of young men. The main sign is elevation of ST segments that can easily mimic an acute STEMI infarction. The ECG changes are often located in leads V1-V4, but sometimes it occurs in leads corresponding with the inferior heart wall (II, III, aVF) and lateral chest leads (V5-V6).

 

EarlyRepolarization - ECGIn this ECG we see the ST elevations in leads V2-V6. If such ECG is recorded in a young individual who is asymptomatic, then the diagnosis of early repolarization is almost clear. Similar finding in a patient suffering from an acute chest pain may be much more challenging.
 

Conclusion: Early repolarization may be a problem in patients with acute non-cardiac chest pain as it ma be mistaken for anterior wall STEMI or even pericarditis. Early repolarization diagnosed in a young asymptomatic person used to be considered completely harmless but now it is assumed that it may be somehow related to an increased risk of ventricular fibrillation occurrence. For this reason, it is advisable to ask the patient about any unclear syncope in personal history and further investigate when the response is positive.