Case 4

The gym enthusiast with chest pain

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•An otherwise fit and well 22 year old presents with chest pain after going to the gym the previous evening. The pain is described as sharp, left-sided pain worse on movement. His examination is unremarkable other than tenderness along the left side of the sternum.

His ECG is shown below.

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What does his ECG show?

•Normal ECG with benign early repolarisation.

ST elevation usually in the anterior leads and < 2mm
High J point
Concave morphology of ST elevation
No reciprocal changes
Stable over time