[Thoracic pain and early repolarization syndrome at the cardiologic emergency unit]

To analyze the clinical and electrocardiographic characteristics of early repolarization syndrome (EP) in patients with thoracic pain.

Patients with thoracic pain and early repolarization were studied. EP was diagnosed on the basis of the presence of two or more criteria: ST elevation; upward concavity; notch or slur on QRS; assymetrical T waves of large amplitude; U waves.

Of 350 patients treated in the emergency department, 17 were studied. Sixteen were men, mean age 43.9 years. Four were black. The thoracic pain was atypical in 15. All the patients had ST elevation with upward concavity, most frequently in leads V2. Tall, peaked, positive waves were found in nine patients and U waves were present in 14.

The electrocardiographic characteristics of ST elevation with upward concavity most frequently observed in precordial leads in patients with atypical precordial pain are important to establish a differential diagnosis, to be confirmed by previous electrocardiogram and cardiac enzymes.