A second cause of non-ischemia related ST segment elevation is shown here. This ECG demonstrates what is referred to as “early repolarization” and is a normal variant, seen most often in younger males. It is from an asymptomatic 37 year old male with no evidence of heart disease, and was recorded as part of a routine examination. Note the following:
- Elevation of the ST segment at the takeoff between the end of the QRS complex and the beginning of the ST segment, seen best in this example in leads V2,and V3 (1). This is referred to as the “J point”
- The distinct notch at the end of the R wave, seen best in leads V4 and V5 (2)
- The fact that the changes are most marked in leads V2-V5, the mid-precordial leads.
- The magnitude of ST elevation is less than 4mm
- The upright and symmetrical T waves are of significantly greater (three to four times) amplitude than the ST elevation.
These are the characteristics of early repolarization