Magnitude and ‘Slur’

The magnitude of ST segment elevation can help to differentiate BER from STEMI: one study reported that 57% of ECGs showing ST elevation due to BER was of 1mm amplitude or less; where the amplitude was 5mm or greater it was due to BER in only 2% of cases [3].

Notch or ‘Slur’ at the end of the QRS segment (at the J point)

One of the features seen in BER is an upward sloping notch at the end of the QRS segment. This is seen more in the precordial leads in BER and is not a feature of pericarditis [3].

Click on the ECG to enlarge.

Learning bite

A notch at the end of the QRS segment is often seen in BER.