EKG: Early Repolarization vs ST Elevation MI
Posted by dkwinter

Source: Academic Life in Emergency Medicine

See also:

EKG Intervals


Formula to differentiate early repolarization from STEMI:

(1.196 x STE60V3) + (0.059 x QTc) – (0.326 x RA V4)

  • STE60V3 = STE elevation height at 60 msec (1.5 small boxes) after the J-point in lead V3 (mm)
  • QTc = The computer-read QTc interval
  • RA V4 = R wave amplitude in lead V4 (mm)

A result of > 23.4 is predictive of a LAD occlusion causing a STEMI, rather than early repolarization.

Reference: http://www.ncbi.nlm.nih.gov/pubmed/?term=22520989


Sample EKG showing early repolarization (reshared from http://hqmeded-ecg.blogspot.ca/2011/12/several-cases-of-st-elevation-from.html)



Excellent post with video of Dr. Smith describing some cases of early repolarization: http://hqmeded-ecg.blogspot.ca/2011/10/inferior-st-elevation-what-is-diagnosis.html