The South African Flag Sign on ECG 🇿🇦. A unique pattern seen in mid-anterior (high lateral) MI due to first diagonal (D1) occlusion. D1, a branch of the LAD, supplies part of the LV's anterior wall & basal anterolateral areas. This sign is characterized by: - ST-segment Elevation: in leads I, aVL, and V2 - ST-segment Depression: in lead III (and often in other inferior leads) This pattern resembles the green Y-shape of the South African flag when visualized on a standard 12-lead ECG display. Culprit Arteries: - First Diagonal Branch (D1) Occlusion: Typically results in isolated ST elevation in leads I and aVL. - Left Circumflex Artery (LCx) Occlusion: May cause ST-segment elevation in leads I, aVL, and V5-6. Clinical relevance Recognizing the South African Flag Sign on ECG is crucial, as high lateral STEMIs are often missed due to non-contiguous ST-segment elevations. Timely identification ensures prompt intervention, reducing the risk of significant cardiac damage. source : liftl.com, clincasequest.hospital

Isolated posterior STEMI is uncommon 3-10% of STEMIs . As suggested usually LCX in dominant system <commonly Ramus as in this case/ or OM . PPCI proximal ramus 2.5x33mm stents . -50% of cases are not recognised as st dep in v1-3 misread as NSTEMI . #cardiology #CardiEd

when someone’s annoyed that mel & langdon keep calling dibs in STEMIs 🤭

Nearly 25% of rota cases in our Institution are ACS (not all are STEMIs, of course)

1/ Type 1 MI: Atherothrombotic Myocardial Infarction This is the "classic heart attack." It occurs when an atherosclerotic coronary plaque ruptures or erodes, triggering thrombus formation and acute coronary artery occlusion. Most STEMIs and many NSTEMIs fall into this category

@AdelTash time is muscle Congrats on the judicious use of progressive technologies to ensure D2B times coupled with rapid decision making to accommodate large volume of STEMIs & PPCI ( mobile cathlabs) Impressive & eager to share ur clinical pathways w the rest of the 🌍

This patient had a negative troponin (done outside). Trop - Great PPV (especially if very high), not so good NPV (if done very early). Trop kits are a precious resource in India. There's no need to do them on obvious STEMIs and potentially delay definitive treatment.

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cardio needs consultants to attend stemis but anyone can gave a go at the brain ?

Bad day to be born 3 code blues — 2 back to back, 2 code obstetrics, 2 code pinks, 2 code stemis It’s only 14:30 ??

NCC: Brockton Hospital is condition Black for STEMIs and Strokes. FAO53 0810

STEMIs are excluded from RECHARGE

2 code strokes 1 PE thrombectomy 2 STEMIS All in a 12 hour period and this is the SMALL hospital 🙃

#Israël Zionist stemis group killing Baby 💔

Missed STEMIs (NSTEMI-OMIs) have ~7.8% in-hospital mortality. That’s higher than than the 1-year mortality after STEMI managed in time. Time is muscle, regardless of ECG criteria. We now have tools to detect a significant proportion of these earlier at acceptable PPV!

Even in major metro areas in the US, about half of all STEMIs walk in.

Sucks for the ER patients with strokes and STEMIs as their vital organs infarct waiting for the ER doc to come back from the ICU 5 floors above them.

Had the same feeling with South Asian health when I saw so many (even my own family) get metabolic syndrome, then STEMIs at a young age. Turns out there really is something there that's largely ignored. Building a new framework for it. Truly feel you are onto something with testosterone and an overall health framework and cant wait to see what comes of it. It'll be big, keep grinding.

Bro really out here crying like a med student who just got his first pager and realized the nurses aren’t his personal Wikipedia CPR dummy combo. “How many nurses know the basics of ECG?” My guy, the same number who’ve caught your missed STEMIs at 3 a.m. while you were busy