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Early repolarisation syndrome and sinus bradycardia – ST elevation, concave upwards, seen in V2-V5 and tall T waves in V2-V5 are features of early repolarisation syndrome (ERPS), hitherto considered a benign condition. In many of these cases, the ST segment becomes isoelectric as the heart rate increases with exercise or vagolytic states. But if the person presents with history of angina, these are contraindicated and serial ECG / estimation of markers of myocardial necrosis are needed. History of angina has to be given due value even if ECG shows only ERPS.
