Shark fin ST elevation has been suggested as a term for merged complexes including a wide QRS, slurred J-point, massive concordant ST deviation and T wave all in one blended complex. This sign looks like the fin of a shark. It is also known as a ‘Giant R-wave”. Its incidence is unknown. It is associated with acute coronary occlusion and has a poor prognosis. This sign can be mistaken for a very wide QRS alone, as the end of the QRS can be hard to distinguish when it blends in to the ST segment so easily. Using multiple leads may make it easier to find the end of the QRS complex.
Total eclipse of the heart – 41 min later with crushing chest pain, just before arrest
Total eclipse of the heart – 40 min later with crushing chest pain