see also:

• The basics of reading an ECG
• patterns of ECGs
• LITFL - an excellent tutorial on BER
• EMRAP TV Episode 36: Benign early repolarization

• BER is thought to be a normal variant
• occurs in 1% of population and at all ages and races but in some 13% of patients presenting to ED with chest pain!
• mainly in those under 50 yrs of age and rarely in those aged > 70yrs
• it's significance is that it is often a confounding ECG finding which can result in mistaken ECG diagnosis of AMI and also mistaken for pericarditis

• ST elevation - usually <5mm (98% of cases)
• upward concavity of the initial portion of the ST segment - usually resulting from an elevated J point
• notching or slurring of the terminal QRS complex - the J point
• almost symmetrical, concordant T waves of large amplitude, although descending part steeper than ascending part
• widespread or diffuse distribution of ST elevation usually greatest in V2-5, but not in aVR, and very rarely only in limb leads.
• relative temporal stability but may change with autonomic tone