[Early repolarization. Differential diagnosis of electrocardiographic ST segment elevation]

'Early repolarisation' (ER) represents a normal electrocardiographic variant with persistent ST segment elevation and is considered a benign condition. ER is found in approximately 1-2% of the population and thus it is common among patients in emergency rooms and coronary care units. ER is not associated with increased mortality or morbidity. The electrocardiographic characteristics of ER include widespread ST segment elevation, upward concavity of the initial portion of the ST segment, notching of the terminal QRS complex, and concordant T waves of large amplitude. The most important differential diagnoses to ER are pericarditis and acute myocardial infarction, AMI. Only through a systematic evaluation in the acute setting are patients with AMI assured the relevant revascularisation therapy. Furthermore patients with ER and without cardiac disease can avoid unnecessary and potentially harmful procedures such as fibrinolysis and coronary angiography.