Early bird gets the worm: Patient follow-up

Find out what the 12-lead ECG uncovered about the patient

-->  Haven't read the initial case presentation? Read: Early bird gets the worm

Let's take another look at the 12-lead ECG.

This 12-lead ECG shows benign early repolarization, a common finding in young males.

The classic presentation is upwardly concave ST-elevation, hooked J-points, and tall T-waves, often most noticeable in lead V4.

This is probably because V4 tends to show the tallest R-waves in the precordial leads. If you look at this example, lead V4 has the tallest R-waves, the most significant ST-elevation, and the tallest T-waves.

Here you can see the classic "hooked J-point" in lead V4 (this finding is not always present with benign early repolarization).

What do we mean by "upwardly concave ST-elevation"?

One easy way to remember is that "upwardly concave" ST-elevation looks like a "smiley face."

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