Podcast 846: Early Repolarization vs. Anterior STEMI

Emergency Medical Minute

Contributor: Travis Barlock, MD

Educational Pearls:

• Early repolarization a benign EKG pattern that can mimic an anterior STEMI
• Can be seen in the anterior leads typically in young male patients
• Can differentiate Early Repolarization vs Anterior STEMI by looking at four variables:
• Corrected QT interval
• QRS amplitude in V2
• R wave amplitude in V4
• ST elevation 60 ms after J point in V3
• These four variables can be plugged into a formula (available on MDCalc)
• Note that a longer QT is more corelated with STEMI

References

Macfarlane PW, Antzelevitch C, Haissaguerre M, et al. The Early Repolarization Pattern: A Consensus Paper. J Am Coll Cardiol. Jul 28 2015;66(4):470-7. doi:10.1016/j.jacc.2015.05.033

Smith SW, Khalil A, Henry TD, et al. Electrocardiographic differentiation of early repolarization from subtle anterior ST-segment elevation myocardial infarction. Ann Emerg Med. Jul 2012;60(1):45-56.e2. doi:10.1016/j.annemergmed.2012.02.015

Summarized by Mark O’Brien, MS4 | Edited by John Spartz, MD, & Erik Verzemnieks, MD

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