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12-Lead Electrocardiographya comprehensive course
Adam Thompson, EMT-P, A.S.
STE-Mimics
Part 3
Benign Early Repolarization (BER)
• BER may present with an appearance of ST-elevation. • Notched J points are the most commonly taught indicator
of “early repol”.• The ST-segment morphology is the easiest way to
determine malignancy of the finding.• LOOK for reciprocal changes!!!
Early Repolarization
Early Repolarization
ST-Segment Morphology
• Concave ST-Elevation is generally more benign.– However, an MI may present with concave
ST-Elevation.
• Convex ST-Elevation is almost always an indication of an MI.
Concave Convex
J-Point J-Point
Benign Early Repolarization
• Notched J-Points are sure indicators of benign early repolarization
Early Repolarization
Early Repolarization
Early Repolarization
Right Bundle Branch Block
• A conduction delay due to blockage of the only right fascicle.
• ST-segment usually not altered by the normal T wave discordance of RBBB.
• QRS duration > 120 ms with positive terminal QRS deflection in V1.
Right Bundle Branch Block
Right Bundle Branch Block
END
• More in the next lesson…