Dr. Smith's ECG Blog

Instructive ECGs in Emergency Medicine Clinical Content

Associate Editors:
— Pendell Meyers & Ken Grauer (2018)
— Jesse McLaren & Emre Aslanger (2022)
— Willy Frick (2024)

editors

Early Repolarization vs LAD Occlusion

First ECG in Video
2nd ECG in Video
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Wide Complex Tachycardia; It's really sinus, RBBB + LAFB, and massive ST elevation

View Comments (4)
  1. Thanks for this. Dr Smith, do you have any case with fish-hook J point which proved to be Ischaemic?

    Jay

  2. Very nice study. I'm alittle confused with your method of measuring the ST segment elevation (whether it be for a STEMI or early repolarization). Is it the J-point plus 40ms (which is what I've seen in many texts and articles? Or is it the J-point plus 60ms like you said? Do you use one method for one situation, and the other for another?

  3. In the study, we measured STE at the J-point AND at 60 ms after the J-point, both relative to the PR segment. It would have been better to measure STE at Jpoint relative to PR, and at 60 ms after the Jpoint relative to TP; but that's not what we did. We also measured the T-wave amplitude, R-wave amplitude, and QTc. Then analyzed to see which are best.

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