SUBSCRIBE for Upcoming Course Announcements

Enroll Now

ECG of the week #21: early repolarization, pericarditis, or STEMI?

Test yourself with this week’s ECG case. Then scroll down for a structured step-by-step interpretation and clinical pearl.

Clinical Scenario

A 75 year old presented with chest pain.

ECG

Question

The final interpretation is “ST elevation, consider early repolarization, pericarditis, or injury”. Which is it?

ECG Analysis

Heart rate/rhythm: sinus with PJC
Electrical conduction: normal intervals
Axis: normal
R-wave progression: normal
Tall/small voltages: normal
ST/T: primary inferior STE/hyperacute T wave, reciprocal I/aVL, and anterior STD

Answer

= infero-posterior STEMI(+) OMI, not early repol or pericarditis. Cath: RCA occlusion

Clinical Pearl

Occlusion MI may have concave ST-segment – but hyperacute T waves ischemic reciprocal ST depression (including anterior STD reciprocal to posterior MI) excludes pericarditis and early repolarization

Share the Post:

Want to get better at ECG interpretation?

Learn with live, interactive, case-based teaching designed to improve ECG interpretation and evidence-based clinical care.
Explore the Courses
In this post

Related Posts