Shark Fin Electrocardiogram: A Deadly Electrocardiogram Pattern in ST-Elevation Myocardial Infarction (STEMI)
Amit K Jaiswal1, Sunil Shah2,3
1Internal Medicine, Ministry of Health, Male', MDV.
Cureus
|August 2, 2021
Summary
The dangerous shark fin ECG pattern, linked to ST-elevation myocardial infarction (STEMI), indicates high mortality risk. Prompt recognition and aggressive reperfusion are crucial for patient survival.
Area of Science:
- Cardiology
- Medical Diagnostics
Background:
- The shark fin electrocardiographic (ECG) pattern, also termed Lambda-wave or giant R waves, is a critical indicator.
- This pattern signifies ST-elevation myocardial infarction (STEMI), a serious cardiac event.
Observation:
- The shark fin ECG arises from the fusion of QRS, ST, and T waves.
- It is associated with a high risk of mortality, often due to cardiogenic shock and ventricular fibrillation.
- A case presenting with STEMI, shark fin ECG, and pulmonary edema (Killip class III) is detailed.
Findings:
- This ECG pattern predicts a grave prognosis, necessitating immediate intervention.
- Misdiagnosis is a concern, as it can be mistaken for wide complex tachycardia or hyperkalemia-induced ECG changes.
Implications:
- Aggressive management, including reperfusion therapy (thrombolysis or percutaneous intervention), is vital.
- Intensive care unit admission with potential ventricular assist devices is recommended for optimal outcomes.
- Accurate differentiation from other conditions with similar ECG presentations is essential for timely and effective treatment.
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