Early Repolarisation in Inferior Leads

Report:

Sinus rhythm 66/min

Inferior ST segment elevation

LVH voltage

Comment:

The unusual elevation is confined to the inferior leads. The slight one in V1-2 is normal. There is also some 0.5 mm depression in aVL, but true reciprocal changes are usually much more widespread and obvious. With respect to pericarditis, the only other differential diagnosis in this case, one would expect significant elevation in other leads as well or, for the cognoscenti, PR segment shifts.

Subjects with early repolarisation often have somewhat bizarre ECGs and the best test is one of time. In this case, a subsequent ECG had virtually identical repolarisation pattern (Fig 50a below).

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