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Some studies categorize early repolarization according to the risk of malignant ventricular arrhythmia into: Precordial Benign Early Repolarization It is the most common and considered a variant of normal EKG changes in (V2-6) Inferolateral Early Repolarization Very rare Reported to have an increased risk of malignant arrhythmia EKG changes in inferior leads (II, III, aVF), or lateral leads (I, aVL, V4-6), or in both locations Global Early Repolarization Very rare Reported to have an increased risk of malignant arrhythmia EKG changes in almost all leads Benign Early Repolarization Concave ST elevations in precordial leads (V1-V6) and I Pericarditis has ST elevations in all leads except (aVR, V1) Fish-hook pattern (V3, V4, III) Pericarditis does not have this fish-hook pattern ST/T = 0.16 This indicates benign early repolarization The patient has benign early repolarization Acute Pericarditis Concave ST elevations and PQ depressions in all leads except (aVR and V1) ST depressions and PQ elevations (aVR and V1) Fish-hook pattern is not present Spodick's sign Descending TP segment (V3-5) The patient has acute pericarditis (stage 1) Benign Early Repolarization Concave ST elevations in almost all leads Precordial (V2-V6) and inferolateral (I, II, III, aVF) Fish-hook pattern (II, III, aVF) High, peaked T waves (V2-V5, II) ST/T = 0.16 This indicates benign early repolarization Benign Early Repolarization, Heart Rate 54/min Sinus Bradycardia ( 54/min ) Concave ST elevations in almost all leads Precordial (V2-V6) and inferolateral (I, II, III, aVF) Fish-hook pattern (II, III, aVF, V4-V6) Benign Early Repolarization, Heart Rate 76/min This is the same patient as on the previous ECG Sinus Rhythm ( 76/min ) The ECG no longer shows sinus bradycardia Signs of benign early repolarization disappear with increasing heart rate Concave ST elevations have decreased Fish-hook pattern has disappeared This ECG does not show typical signs of BSR These signs were present in the previous ECG with bradycardia Benign Early Repolarization Concave ST elevations in almost all leads Precordial (V2-V6) and inferolateral (I, II, III, aVF) Fish-hook pattern (V4-6) High, peaked T waves (V2-V3) ST/T = 0.2 Indicating benign early repolarization Acute Pericarditis Concave ST elevations and PQ depressions in all leads except (aVR) Benign early repolarization (BSR) does not have PQ depressions No fish-hook pattern in precordial leads ST/T = 0.33 Indicating pericarditis Patient has pericarditis (stage 1) Acute Pericarditis Sinus Tachycardia (110/min.) Concave ST elevations and PQ depressions in all leads except (aVR and V1) Benign early repolarization (BSR) does not have PQ depressions No fish-hook pattern present The patient has pericarditis (stage 1) Sources ECG from Basics to Essentials Step by Step litfl.com ecgwaves.com metealpaslan.com medmastery.com uptodate.com ecgpedia.org wikipedia.org Strong Medicine Understanding Pacemakers
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