Benign early repolarization

A common electrocardiographic finding in healthy individuals

Benign early repolarization (BER) is a common electrocardiographic (ECG) finding that is often seen in healthy individuals. It is characterized by specific changes in the ECG that are considered normal and not indicative of any underlying heart disease. This condition is most frequently observed in young adults and athletes.

Electrocardiographic Features

Semantic confusion early repolarization

The hallmark of benign early repolarization on an ECG is the presence of J-point elevation, which is the point where the QRS complex transitions into the ST segment. This elevation is typically seen in the inferior and lateral leads of the ECG. Other features may include:

• ST segment elevation: The ST segment may be elevated, but it is usually concave upwards.
• Notching or slurring of the terminal QRS complex: This is often seen in the lateral leads.
• Absence of reciprocal changes: Unlike pathological conditions, BER does not show reciprocal changes in other leads.

Clinical Significance

Benign early repolarization is considered a normal variant and is not associated with an increased risk of cardiovascular events in most individuals. However, it is important to differentiate BER from other conditions that can cause similar ECG changes, such as myocardial infarction or pericarditis.

Differential Diagnosis

Benign early repolarization ECG example

The differential diagnosis for ECG changes similar to benign early repolarization includes:

• Acute myocardial infarction: Unlike BER, myocardial infarction is associated with reciprocal changes and clinical symptoms such as chest pain.
• Pericarditis: This condition can also cause ST segment elevation, but it is usually associated with a pericardial rub and widespread ST elevation.
• Brugada syndrome: This is a genetic condition that can cause similar ECG changes but is associated with a risk of sudden cardiac death.

Management

In most cases, benign early repolarization does not require any specific treatment or intervention. It is important for healthcare providers to recognize this pattern to avoid unnecessary testing and anxiety for the patient. Regular follow-up and monitoring may be recommended in some cases to ensure that the ECG changes remain consistent with benign early repolarization.

Related Pages

• Electrocardiography
• Myocardial infarction
• Pericarditis
• Brugada syndrome