Does one ECG showing early repolarization and ST elevation with sinus bradycardia (55bpm in sedentary, unfit 45 y.o male), sinus arrhythmia, normal T wave inflection, together with a family history of heart attacks in males (unknown cause and type) warrant further investigation to differentiate benign early repolarization from other conditions? What are the other conditions? What tests should be done?
No chest pain, perhaps occasional discomfort (could be referred pain from back condition).
Cervical Radiculopathy (numb left arm on waking)
No blood tests done yet.
Distant history of renal stones, elevated calcium in urine, plasma levels unknown
While I don't expect a follow-up....
I got a copy of the ECG traces and put together more details if anyone's interested. Since I don't have a scanner I've used a shorthand that I think might be able to be followed if I've got my QRS's right.
Trying not to be alarmist but silent MI (STEMI) or impending MI a possibility? What's with S waves?
I R5 S3
II Q 1 R15 ST 1 elevated
III Q 1 R 13 ST 1 elevated slurred J
V1 R 1 S 7 no T
V2 R 5 S 8 ST 1 elevated slow J point transition into T
V3 R 7 S 4 ST 2 elevated
V4 R 16 S 2 ST 2 elevated sharp transition at J
V5 tiny Q notch R 21 S1 ST 2 elevated sharp transition at J
V6 Q 1 R 21 ST 2 elevated sharp transition at J
aVR corresponding T attack concavity
aVL R 1 S 7 v small ST 1
aVF Q 1 R14 ST 1 elevated
Numbers are amplitudes in small squares
Any negative deflection is considered a Q even 1 small square
All 'ST' transitions early except aVF. Repolarization starts early on all T's except V1 where there's no T (doh?)
All T are asymetrical and peaky with concave attack and faster decay.
QRS duration appears a little broader on V1, V2 & V3
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