Shark Fin morphology recognized only by EM physician
This ECG is from a man in his 70s who complained of acute chest pain followed by a witnessed cardiac arrest. This ECG was taken after ROSC following 35 min down time.
This ECG shows Shark-fin morphology with RBBB + LAFB and massive anterolateral ST elevation. The cause was an acute proximal LAD occlusion.
A woman in her 70s with chest pain
This ECG is from a woman in her 70s who presented with central chest pain. This was the initial ECG.
This ECG shows ST elevation in V1-2 with ST depression in V4-6 as well as I, II and aVF. R wave progression is also poor. V1 is concerning for a hyperacute T wave. The chest pain worsened and the ECG changes evolved to meet STEMI criteria. Troponin was elevated. Catheterisation found a 100% proximal LAD occlusion.