Acute left main coronary artery occlusion with South African flag sign on electrocardiogram: a case report - Takeaways - MDSpire

Acute left main coronary artery occlusion with South African flag sign on electrocardiogram: a case report

  • By

  • Fangming Zhong

  • Baiqing Lin

  • Qifeng Zhang

  • July 8, 2026

  • 0 min

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  • 1

    The South African flag sign (SAFS) on ECG may indicate acute high lateral wall myocardial infarction, typically linked to first diagonal branch occlusion.

  • 2

    A 69-year-old woman with primary hypertension presented with chest pain and SAFS, initially diagnosed with high lateral myocardial infarction.

  • 3

    Emergency coronary angiography revealed a complete occlusion of the left main coronary artery (LMCA) with no collateral flow.

  • 4

    The patient underwent successful percutaneous coronary intervention (PCI), restoring optimal blood flow and leading to an uneventful recovery.

  • 5

    This case highlights the importance of clinical vigilance when interpreting ECG patterns like SAFS, which may indicate severe coronary artery pathology.

Original Source(s)

Acute left main coronary artery occlusion with South African flag sign on electrocardiogram: a case report

  • by Fangming Zhong, Baiqing Lin, Qifeng Zhang

  • July 8, 2026

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