Emergency Medical Minute30 Jan 2023

Podcast 846: Early Repolarization vs. Anterior STEMI

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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