STEMI vs BER source?

[irrka]

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I'm looking for a good explanation of how to tell STEMI from BER that's not just the concave convex standard speil. Anyone? anyone?

 

[southerndoc]

OK, I'm stupid: what's BER?

 

[goofE1]

I think by BER he means benign early repolarization, but I've never actually seen the abbreviation used before.

 

[Apollyon]

I was figuring clinical presentation - treat the patient, not the monitor. If the patient is sitting there comfortably, I'll think benign early repol. If they are exhibiting "Levine's sign", are visibly short of breath, diaphoretic, or just looking "crumpy", then STEMI is more likely.

 

[Interpolfanclub]

emrap.tv has a good summary with amal mattu

 

[irrka]

thanks, i'll check that out. yeah for some reason i kept coming accross it being abbreviated as BER so it stuck in my head. watched a 28yo looking like a peach and something that for all the world looked like a stemi on the ekg get thrombolysed yesterday so i'm freaking out a fair bit. aaand the first trop was negative.

update: feel somewhat better after watching that

 

[Arcan57]

Just had an 18yo come in with CP from a minor care because of an EKG with early repole. No CP when I saw him, EKG showed early repole in the ED. Troponin came back at 4.5. The pt had a URI a couple of weeks earlier so I still think it's more likely to be myocarditis.