No se les ocurra compartir esta imagen del Alto Palermo porque el periodismo que promueve el apocalipsis se va a poner muy mal... y algunos hasta te pueden hacer amenazar por sus familia directos...
CIAO!
🎉¡Finde otra vez! ¿Te estás preparando?
Este sábado y domingo, de 10 a 19.30, una buena opción para disfrutar del descanso es darte una vuelta por el Museo. ¿Hace cuánto tiempo que no visitás el Bellas Artes?
Aquí todo lo que podés ver y hacer: bellasartes.gob.ar
Con “La vuelta del malón” (1892), obra maestra del arte argentino y una de las preferidas de los visitantes del Bellas Artes, recordamos a su autor, el artista Ángel Della Valle, nacido en Buenos Aires #UnDíaComoHoy de 1852. La pieza se exhibe en la planta baja del Museo.
ECG From Scratch #50: The South African Flag Sign 🇿🇦🇿🇦
Some coronary occlusions do not produce the classic STEMI pattern you expect.
One of the most memorable is the South African Flag Sign (SAFS), an ECG pattern associated with high-lateral/anterolateral occlusion, classically involving the first diagonal branch (D1) of the LAD.
The pattern:
- ST elevation: I, aVL and V2
- ST depression: III, often also aVF
- The unusual distribution resembles the South African flag when the ECG is displayed in a standard 4×3 format.
Why V2?
This is what makes the pattern easy to miss.
D1 usually supplies the anterolateral LV, but a large/proximal D1 can supply part of the upper anterior or anteroseptal region, producing ST elevation in V2.
Therefore, isolated V2 elevation does not automatically mean a classic LAD septal infarction.
Why does it matter?
SAFS may represent acute coronary occlusion without meeting conventional STEMI criteria.
A 2025 case series described four patients with the pattern. Two had acute D1 occlusion requiring PCI, while others had non-obstructive coronary findings, illustrating an important limitation:
SAFS is a warning pattern, not proof of D1 occlusion.
And there is an even newer twist.
A 2025 case report documented the same ECG pattern with acute ramus intermedius occlusion, demonstrating that SAFS is not anatomically exclusive to D1.
The modern OMI perspective
The important question is not simply:
(Does this meet STEMI criteria?)
The more clinically useful question is:
(Could this ECG represent an acute coronary occlusion?)
The 2023 ESC ACS guideline explicitly recognizes that acute coronary occlusion can sometimes require immediate reperfusion despite the absence of conventional ST-elevation criteria. Patients with a high suspicion of ongoing coronary occlusion should undergo emergency angiography as soon as possible.
So, in a patient with acute ischemic symptoms:
SAFS + concerning clinical presentation = take the pattern seriously.
Do not dismiss it simply because the ST elevations are non-contiguous or because the ECG has been labeled NSTEMI.
But don't overdiagnose it
SAFS is not currently a standalone STEMI-equivalent criterion in major international guidelines, and its diagnostic accuracy for D1 occlusion remains uncertain. The 2025 case series itself demonstrated that the pattern can occur without a D1 occlusion.
Think of it as an OMI clue that should trigger careful evaluation, not as a substitute for clinical assessment and coronary angiography.
@TrackYourHeart
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