Early Repolarization suggested by:<unk>  elevation <4mm
Notched J point
Concave or saddle-back<unk>  morphology
No reciprocal changes
Consistent over short term
Young patient without risk factors<unk>  elevation <4mm
Notched J point
Concave or saddle-back<unk>  morphology
No reciprocal changes
Consistent over short term
Young patient without risk factors
Difficult to exclude MI in patient with LVH (patients with LVH are already at risk for MI)
Best aid is prior ECG or serial ECGs
See Sgarbossa's Criteria<unk>  elevation in those leads that reflect the distribution of a single coronary artery
RCA: II, III, aVF (inferior)
LAD: V1-V4 (antero-septal)
Circumflex: V5-V6, I, aVL (lateral)
Dominant left circulation: infero-lateral<unk>  morphology
Concave up versus convex
Convex has Sp 97%, Sn 77%
Look for reciprocal<unk>  depression
35% of anterior<unk> MI have<unk>  depression in inferior leads
80% of inferior<unk> MI have<unk>  depression in anterior leads
However, may represent reciprocal changes OR posterior<unk> MI
RCA: II, III, aVF (inferior)
LAD: V1-V4 (antero-septal)
Circumflex: V5-V6, I, aVL (lateral)
Dominant left circulation: infero-lateral
Concave up versus convex
Convex has Sp 97%, Sn 77%
Convex has Sp 97%, Sn 77%
35% of anterior<unk> MI have<unk>  depression in inferior leads
80% of inferior<unk> MI have<unk>  depression in anterior leads
However, may represent reciprocal changes OR posterior<unk> MI
However, may represent reciprocal changes OR posterior<unk> MI
Reciprocal<unk> gment depression in at least one of leads II, III, aVF
Occurs in 40-70% of cases
Reciprocal<unk> gment depression usually present in I, aVL; often in V1-V3
Occurs in 56% of cases
Reciprocal<unk> gment depression in V1-V4
Differentiate from inf<unk> MI reciprocal depression based on upright T waves, posterior leads showing<unk> MI
Often associated with<unk>  in II, III, aVF (inferior involvement)
Differentiate from inf<unk> MI reciprocal depression based on upright T waves, posterior leads showing<unk> MI

>6mm limb leads
>10mm precordial leads

0.1mV in two or more contiguous leads
ST segment elevation
Cardiac
ST segment depression
ST-segment elevation myocardial infarction 
T wave changes
Post-MI 
QT prolongation
Previous MI with recurrent ischemia in same area