ECG Quest > Diagnoses > Other > Normal ST elevation

Normal ST elevation

Normal variant ST elevation can occur in healthy, often young, patients. It is very important to differentiate it from acute ischemia. It has also been known as Benign Early Repolarisation.

Typical features of normal ST elevation include:

  • Concave ST elevation, most often in the anterior leads
  • J waves / J wave notching
  • Absence of reciprocal ST depression
See also: Other

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In the ECGquest archives, this ECG has been tagged with: - Anterior ST elevation Inferior ST elevation Lateral ST elevation Normal ST elevation Normal vs. abnormal anterior ST elevation 12-Lead Dr Smith's ECG Blog CC BY-NC
A 60-something with syncope

This ECG is from a man in his 60s who had a witnessed sudden loss of consciousness and awakening.

This ECG shows widespread ST elevation without reciprocal ST depression. Angiography was normal.

In the ECGquest archives, this ECG has been tagged with: - Tall QRS Normal ST elevation 12-Lead Dr Smith's ECG Blog CC BY-NC
Is this terminal QRS distortion? Is there LVH?

This ECG is from an otherwise healthy, thin, African American male.

This ECG shows high voltage QRS and ST elevation with J waves, without discordant ST depression and T wave inversion, likely due to early repolarisation in a young person with a thin chest wall.

In the ECGquest archives, this ECG has been tagged with: - Seizure J wave Widespread ST elevation Normal ST elevation 12-Lead Dr Smith's ECG Blog CC BY-NC
A Young Man with Sharp Chest pain

This ECG is from a teenage male who had a seizure.

This ECG shows diffuse ST elevation with prominent J waves and no reciprocal ST depression. The most likely cause was early repolarisation.

In the ECGquest archives, this ECG has been tagged with: - Anterior ST elevation J wave Lateral ST elevation Normal ST elevation Normal vs. abnormal anterior ST elevation 12-Lead Dr Smith's ECG Blog CC BY-NC
Three EKGs shown to me – which if any need emergent reperfusion?

This ECG is from a man in his 30s with unknown symptoms.

This ECG shows ST elevation (false positive) with clear J waves. Angiogram, troponins and serial ECGs were normal.

In the ECGquest archives, this ECG has been tagged with: - Anterior ST elevation Normal ST elevation 12-Lead Dr Smith's ECG Blog CC BY-NC
Chest pain and Convex ST Elevation in Precordial Leads

This ECG is from a man in his 30s who presented with chest pain for a week on a background of anxiety, asthma and alcohol use disorder.

This ECG shows ST elevation in V2-6, with convexity. Serial ECGs showed no evolution and serial troponins did not rise. The 4-variable formula gives a false positive with this ECG due to the convexity.

In the ECGquest archives, this ECG has been tagged with: - Abdominal pain Chest pain Anterior ST elevation Normal ST elevation 12-Lead Dr Smith's ECG Blog CC BY-NC
Saddleback ST Elevation. Is it STEMI? Is it type II Brugada? Repeat ECG.

This ECG is from a man in his 50s who presented with epigastric and chest pain.

This ECG shows normal variant ST elevation.

In the ECGquest archives, this ECG has been tagged with: - Anterior ST elevation Lateral ST elevation Normal ST elevation 12-Lead Dr Smith's ECG Blog Dr Ken Grauer CC BY-NC
A 58 year old with Weakness and more than 4 mm ST Elevation in V3

This ECG is from a man in his 50s who presented with lightheadedness. He was alert, sweating and felt weak. There was no chest pain. He had no past medical history, medications or risk factors for coronary disease.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Normal ST elevation 12-Lead Dr Smith's ECG Blog CC BY-NC
Chest pain and T-wave inversion in lead V2: repeat ECG with electrodes repositioned

This ECG is from a healthy young man who presented with chest pain. This was the repeat ECG after the electrodes had been repositioned.

In the ECGquest archives, this ECG has been tagged with: - Chest pain Palpitations Irregular Anterior ST elevation J wave Widespread ST elevation Atrial fibrillation Normal ST elevation 12-Lead Dr Smith's ECG Blog CC BY-NC
Palpitations and Chest Tightness: Should You Activate the Cath Lab (or Give Thrombolytics)?

This ECG is from a man in his 20s with palpitations and chest tightness on a background of Wolff Parkinson White syndrome.