If a patient with ERS (Early repolarisation syndrome) develop an ACS what happens to the ST segment ?
Will just present like any other STEMI and evolve in a classical fashion.
ERS patients are more likely to present as Hyperacute Tall T waves than a true ST elevation
No significant ST elevation may be noted as baseline itself is shifted up
Acute transmural Ischemia tends to normalise the ST elevation and there is a clear risk of missing ACS !
There will be more dramatic ST elevation and confers a heightened risk of primary VT or VF
If its NSTEMI , the ST segment returns to baseline and could completely confuse the cardiologist !
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