Podcast 846: Early Repolarization vs. Anterior STEMI

<p><strong>Contributor: Travis Barlock, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Early repolarization a benign EKG pattern that can mimic an anterior STEMI</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Can be seen in the anterior leads typically in young male patients</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Can differentiate Early Repolarization vs Anterior STEMI by looking at four variables:</span></li> <ul> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">Corrected QT interval</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">QRS amplitude in V2</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">R wave amplitude in V4</span></li> <li style="font-weight: 400;" aria-level="2"><span style= "font-weight: 400;">ST elevation 60 ms after J point in V3</span></li> </ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">These four variables can be plugged into a formula (available on MDCalc)</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Note that a longer QT is more corelated with STEMI</span></li> </ul> <p> </p> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Macfarlane PW, Antzelevitch C, Haissaguerre M, et al. The Early Repolarization Pattern: A Consensus Paper.</span> <em><span style="font-weight: 400;">J Am Coll Cardiol</span></em><span style="font-weight: 400;">. Jul 28 2015;66(4):470-7. doi:10.1016/j.jacc.2015.05.033</span></p> <p><span style="font-weight: 400;">Smith SW, Khalil A, Henry TD, et al. Electrocardiographic differentiation of early repolarization from subtle anterior ST-segment elevation myocardial infarction.</span> <em><span style="font-weight: 400;">Ann Emerg Med</span></em><span style="font-weight: 400;">.