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Patient
Young man 19 years of age, athletic, of African descent, with no cardiovascular history;
Trace
Characteristic tracing of early repolarization with over-elevation of the J point > 1 to 2 mm in the inferior and mid precordial leads and left lateral leads (V3 to V6) with an slurring or notching of the terminal portion of the QRS depending on the leads; absence of reciprocal depression with the exception of the aVR lead; significant voltage of the QRS and T-waves that are consistent with the QRS (same polarity); QRS transition between V2 and V3;
Exergue
The discovery of an early repolarization on the ECG of an asymptomatic patient is a relatively frequent occurrence long considered benign. While an overwhelming majority of patients with this pattern do not have an increased risk of sudden death, there appears to be a higher prevalence of early repolarization among survivors of ventricular fibrillation.
The early repolarization pattern has long been considered as a benign variant of normal observed predominantly in young, athletic, black and male patients with a tendency to disappear on exertion.