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Benign Early Repolarization (BER)

  • ST elevation in many leads (usually 1-2mm in height) but it has a fish hook appearance (could be very small)
  • Look particularly in leads V2, V3, V4 and V5. The fish hook appearance off the QRS is most noticeable in these leads
  • A normal benign variation that has no clinical significance
  • It usually occurs in people less than 50 yrs old (if seen in older patients, investigate for AMI due to the risk factors of that age population).
  • Remember the happy, sad, straight face? This is the happy ST elevation
  • Signs best seen in V4. It is most noticeable here because the lover V leads focus more on the ventricles than the other leads. The waveforms will look larger = able to pick out anomalies with depolarization and repolarization more easily.

Contact

Ministry of Health and Long-Term Care
5700 Yonge Street, 6th Floor
Toronto, ON M2M 4K5

416-327-7900

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