Key result
South African flag sign on ECG observed in 100% proximal LAD rather than isolated diagonal occlusion.
Why the study?
The South African flag sign is typically linked to first diagonal artery occlusion, but its relationship to other coronary lesions requires reporting.
Case Report (n=1)
The South African flag sign on ECG may indicate proximal LAD occlusion and severe multivessel disease, not just isolated first diagonal artery occlusion.
The South African flag sign (SAFS) is an acute, dynamic electrocardiographic (ECG) finding typically associated with first diagonal (D 1 ) artery occlusion. We report the case of a 47-year-old woman who exhibited this pattern but subsequently revealed the dreaded “widow-maker” lesion (100% occluded proximal left anterior descending [LAD] artery) and severe multivessel disease (90% stenosis of the posterior left ventricular [PLV] artery and 80% stenosis of the left circumflex artery [LCx]).
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Swarath et al. (2023) conducted a case report in Acute myocardial infarction with South African flag sign (n=1). Electrocardiography (South African flag sign) was evaluated on Coronary anatomy findings. The South African flag sign on ECG was observed in a patient with a 100% occluded proximal left anterior descending artery and severe multivessel disease, rather than isolated diagonal occlusion.
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