Key result
South Africa Flag' ECG sign indicates life-threatening ostial D1 occlusion in high lateral STEMI.
The 'South Africa Flag' ECG sign is a critical bedside indicator of a life-threatening ostial occlusion of the first diagonal branch of the LAD.
No takes yet. Share an insight, caveat, or question.
Expedites cath lab activation in high lateral STEMI; extends ECG recognition of ostial D1 occlusion but remains hypothesis-generating.
A 43-year-old male without traditional risk factors presented with an acute high lateral ST-elevation myocardial infarction (STEMI). The electrocardiogram (ECG) revealed the distinctive 'South Africa Flag' sign. A significantly elevated troponin-I level (25 ng/mL) corroborated extensive myocardial injury. Emergency coronary angiography identified an ostial occlusion of the first diagonal (D1) branch of the left anterior descending artery as the culprit lesion, which was successfully treated with percutaneous coronary intervention (PCI). This case exemplifies the critical importance of recognizing this ECG pattern as an urgent bedside indicator of a life-threatening D1 occlusion.
Subrata Lahiri1*, Ovais Rashid2, Deepak Tomar3, Anshu Goel4 (2026) studied this question. The 'South Africa Flag' sign on ECG serves as a critical bedside indicator of life-threatening ostial D1 occlusion in high lateral STEMI cases.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: