Shark fin ECG pattern in a patient with acute ascending aortic dissection

Area of Science:

• Cardiology
• Emergency Medicine
• Cardiovascular Surgery

Background:

• The 'shark-fin' electrocardiogram (ECG) sign is a recognized, albeit rare, finding in Acute Coronary Syndrome (ACS), often indicating a poor prognosis.
• The presence and significance of the 'shark-fin' ECG pattern in the context of acute aortic syndromes, such as aortic dissection, are not well-established.
• Acute aortic syndromes represent a spectrum of life-threatening conditions involving the aorta, requiring prompt diagnosis and management.

Purpose of the Study:

• To report a case of Ascending Aortic Dissection presenting with the characteristic 'shark-fin' ECG pattern.
• To explore the potential association between the 'shark-fin' ECG sign and acute aortic dissection.
• To raise awareness among clinicians regarding this ECG finding in the emergency department (ED) setting.

Main Methods:

• Case report of a patient presenting to the Emergency Department (ED) with acute chest pain.
• Electrocardiogram (ECG) interpretation revealing the 'shark-fin' pattern.
• Diagnostic workup including imaging to confirm Ascending Aortic Dissection.

Main Results:

• The patient presented with acute chest pain and exhibited a distinct 'shark-fin' ECG pattern.
• Subsequent diagnostic evaluation confirmed the diagnosis of Ascending Aortic Dissection.
• The 'shark-fin' ECG pattern, typically associated with ACS, was observed in this case of aortic dissection.

Conclusions:

• The 'shark-fin' ECG sign, while rare, can manifest in patients with Ascending Aortic Dissection.
• This case suggests that the 'shark-fin' ECG pattern may not be exclusive to ACS and warrants consideration in the differential diagnosis of acute aortic syndromes.
• Further research is needed to understand the prevalence and prognostic implications of the 'shark-fin' ECG sign in acute aortic syndromes.