Shark Fin Sign in ECG
Shark Fin Sign in ECG
Shark Fin Sign in ECG – 20 Advanced Points
1. Definition
Fusion of QRS complex, ST segment, and T wave into a large triangular waveform.
2. Shape
The waveform resembles a shark’s dorsal fin — hence the name.
3. Common Leads
Most evident in precordial leads (V2–V5).
4. Indicates
Often signifies massive ST-elevation myocardial infarction (STEMI).
5. Alternative Name
Also called “triangular QRS-ST-T waveform” or “lambda wave.”
6. Cause
Caused by extensive myocardial injury and transmural ischemia.
7. Loss of Normal ECG Segments
Boundaries between QRS, ST segment, and T wave disappear.
8. Associated Artery
Typically linked to proximal LAD (left anterior descending) artery occlusion.
9. Mimics
May mimic ventricular tachycardia (VT) or hyperkalemia on ECG.
10. Clinical Setting
Common in anterior STEMI with rapid clinical deterioration.
11. ECG Risk Marker
Associated with high risk of cardiogenic shock or sudden cardiac arrest.
12. Urgency
Medical emergency requiring immediate reperfusion (PCI or thrombolysis).
13. ECG Clues to Differentiate from VT
Presence of P waves, lack of AV dissociation, and consistent morphology help.
14. Important Differentiation
Distinguish from hyperkalemia, which also causes broad waveforms.
15. Role of Echocardiography
Helpful in evaluating wall motion abnormalities and excluding mimics.
16. Mortality Implication
Indicates a large infarct area, associated with poor prognosis if untreated.
17. First Reported By
Initially described in the context of massive MI with ST-elevation.
18. Post-MI Complication Indicator
May precede ventricular arrhythmias or mechanical complications.
19. Management Protocol
Activate cath lab immediately, give aspirin, oxygen, and possibly fibrinolytics.
20. Why It’s Missed
Can be under-recognized due to resemblance to wide-complex tachyarrhythmias.
The V3 through V6 leads showed giant R waves (amplitude ≥1 mV) that merged with markedly elevated ST segments, which formed a triangular morphology known as the same configuration called shark-fin sign and lambda-wave pattern
Shark Fin Sign in ECG
The V3 through V6 leads showed giant R waves (amplitude ≥1 mV) that merged with markedly elevated ST segments, which formed a triangular morphology known as the same configuration called shark-fin sign and lambda-wave pattern
